증상이 있는 신생아 자발성 기흉의 관련 질환과 예후
Symptomatic Spontaneous Pneumothorax in the Newborn : Comorbidities and Outcomes
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Purpose : This study was performed to determine the rate of neonatal symptomatic spontaneous pneumothorax, and the corresponding clinical characteristics, co-morbidities, and outcomes. Methods : The demographic characteristics, clinical symptoms and signs, associated abnormalities, methods of treatment, and outcomes were investigated in 22 neonates with symptomatic spontaneous pneumothorax in the neonatal intensive care unit (NICU) of Chonnam University Hospital between March 2003 and February 2008. Results : The rate of spontaneous pneumothorax was 0.55%. Among the 22 neonates, the number of outborns was 15 (68.2%) and the number of males was 12 (54.5%). The main symptoms and signs were chest retraction, tachypnea, and cyanosis. The pneumothoraces were more frequent on the right side (59.1%) and all cases were diagnosed within 3 days of life. Four cases (18.2%) had urologic abnormalities and 7 cases (31.8%) had cranial abnormalities by ultrasonography. The treatments included oxygen (81.8%) and oxygen with chest tube drainage (18.2%). All of the infants survived and the overall outcomes were favorable. Conclusion : When respiratory symptoms and signs are develop abruptly in otherwise healthy newborns, the clinician should suspect a spontaneous pneumothorax and check a chest x-ray as soon as possible. Although the outcome of neonatal symptomatic spontaneous pneumothorax is favorable, renal and cranial ultrasonography are needed because of the higher possibility of urologic abnormalities and germinal matrix/intraventricular hemorrhage than in newborns without a pneumothorax.
Abstract
Purpose : This study was performed to determine the rate of neonatal symptomatic spontaneous pneumothorax, and the corresponding clinical characteristics, co-morbidities, and outcomes. Methods : The demographic characteristics, clinical symptoms and signs, associated abnormalities, methods of treatment, and outcomes were investigated in 22 neonates with symptomatic spontaneous pneumothorax in the neonatal intensive care unit (NICU) of Chonnam University Hospital between March 2003 and February 2008. Results : The rate of spontaneous pneumothorax was 0.55%. Among the 22 neonates, the number of outborns was 15 (68.2%) and the number of males was 12 (54.5%). The main symptoms and signs were chest retraction, tachypnea, and cyanosis. The pneumothoraces were more frequent on the right side (59.1%) and all cases were diagnosed within 3 days of life. Four cases (18.2%) had urologic abnormalities and 7 cases (31.8%) had cranial abnormalities by ultrasonography. The treatments included oxygen (81.8%) and oxygen with chest tube drainage (18.2%). All of the infants survived and the overall outcomes were favorable. Conclusion : When respiratory symptoms and signs are develop abruptly in otherwise healthy newborns, the clinician should suspect a spontaneous pneumothorax and check a chest x-ray as soon as possible. Although the outcome of neonatal symptomatic spontaneous pneumothorax is favorable, renal and cranial ultrasonography are needed because of the higher possibility of urologic abnormalities and germinal matrix/intraventricular hemorrhage than in newborns without a pneumothorax.
참고문헌 (18)
- Chernick V, "Pneumothorax and chylothorax in the neonatal period", J Pediatr, 76, pp.624~632 (1970)
- Kresmery P, "Pneumothorax in the newborn", Neonatal Netw, 19, pp.62~63 (2000)
- Van Schil PE, "Current management of spontaneous pneumothorax", Monaldi Arch Chest Dis, 63, pp.204~212 (2005)
- Ehrlich PF, "Extrapulmonary extravasation of air (pneumothorax, pneumomediastinum, pulmonary interstitial emphysema). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson textbook of pediatrics. 18th ed", pp.750~752 (2007), WB Saunders Co
- Venkatesh MP, "Pulmonary air leak. In Manual of neonatal care. 6th ed.", pp.352~358 (2008), Lippincott Williams & Wilkins
- Ashkenazi S, "Renal anomalies in neonates with spontaneous pneumothorax incidence and evaluation", Int J Pediatr Nephrol, 4, pp.25~27 (1983)
- Dykes FD, "Intraventricular hemorrhage: a prospective evaluation of etiopathogenesis", Pediatr, 66, pp.42~49 (1980)
- MehraBni D, "Association of pneumothorax and hypotension with intraventricular hemorrhage", Arch Dis Child, 66, pp.48~51 (1991)
- Park SW, "A clinical study about symptomatic spontaneous pneumothorax", Korean J Perinatol, 17, pp.304~309 (2006)
- Papile LA, "Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm", J Pediatr, 92, pp.529~534 (1978)
- Thibeault DW, "Pulmonary interstitial emphysema, pneumomediastinum and pneumothorax. Occurrence in the newborn infants", Am J Dis Child, 126, pp.611~614 (1973)
- Bernhard WF, "A study of the pathogenesis and management of spontaneous pneumothorax", Dis Chest, 42, pp.403~412 (1962)
- Wyatt TH, "Pneumothorax in the neonate", J Obstet Gynecol Neonatal Nurs, 24, pp.211~216 (1995)
- Katar S, "Symptomatic spontaneous pneumothorax in term newborns", Pediatr Surg Int, 22, pp.755~758 (2006)
- Al Tawil K, "Symptomatic spontaneous pneumothorax in term newborn infants", Pediatr Pulmonol, 37, pp.443~446 (2004)
- Yang JH, "A multi-center study for birth defect monitoring systems in Korea", J Korean Med Sci, 19, pp.509~513 (2004)
- Cooke RW, "Pneumothorax, mechanical ventilation, and periventricular hemorrhage", Lancet, 1, pp.555~ (1981)
- Sheth RD, "Trends in incidence and severity of intraventricular hemorrhage", J Child Neurol, 9, pp.176~185 (2002)