title: [Pulmonary air-leakage in newborn infants].
abstract: BACKGROUND
  Pulmonary air-leakage (PAL), especially pneumothorax, is a potentially severe complication of pulmonary disease in newborn infants. It is often related to therapeutic procedures such as resuscitation and mechanical ventilation.
  
  
  METHODS
  This is a prospective study of infants with PAL who were born in the period 1989-2006 and were hospitalised in an intensive care unit.
  
  
  RESULTS
  PAL occurred in 54 of 39,101 (1.4 per 1000) live-born infants; 34/54 (63%) were boys and 34/54 (63%) were born at term. 38/54 (70%) PAL cases had asphyxia and different pulmonary diseases, 16/54 (30%) PAL-incidences occurred spontaneously and 23/54 (43%) were diagnosed < 1 hour after birth. PAL occurred during resuscitation for perinatal asphyxia or initiation of mechanical ventilation in 18/54 (33%) patients, during CPAP-treatment in 12/54 (22%), and during mechanical ventilation after the start-up phase in 8/54 (15%) patients. Of 271 infants treated with mechanical ventilation, 144 (53%) were preterm infants with RDS. 64/114 (born 1992-2006) of these received a porcine surfactant and 3/64 (5%) developed PAL. The remaining 50 ventilated RDS-patients born in the same time period had a milder disease; 3/50 (6%) of these developed PAL (p > 0.05).
  
  
  CONCLUSIONS
  PAL often occurred spontaneously and shortly after birth in connection with resuscitation and stabilization for respirator treatment. The risk for PAL in mechanically ventilated infants was lower once the start-up process had been completed. In infants who had received porcine surfactant for RDS the incidence of PAL during mechanical ventilation was low.
authors: Barnesenteret, Sykehuset i Vestfold, 3103 Tønsberg. alfmeb@start.no.
authors: Alf
authors: A
authors: Meberg
authors: Margrethe
authors: M
authors: Greve-Isdahl
authors: Cathrine Alsaker
authors: CA
authors: Heier
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008478:Mediastinal Emphysema / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011030:Pneumothorax / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D011663:Pulmonary Surfactants / Q000008:administration & dosage; D012121:Respiration, Artificial / Q000009:adverse effects*; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy / Q000628:therapy; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D011663:Pulmonary Surfactants