title: [Pneumothorax during mechanical ventilation--therapeutic options in term and preterm neonates].
abstract: A pneumothorax (PTX) is a potentially life threatening event during mechanical ventilation. Aim of this study was to analyse 3 different ways of management: expectant treatment, once-only pleural puncture and thoracic drainage.Retrospective data analysis in term and preterm neonates admitted to the NICU of the Medical University of Graz (between 2000-2010) and Innsbruck (2002-2010) who suffered from a PTX during continuous positive airway pressure (CPAP) or conventional mechanical ventilation (CMV).104 neonates, 33 term and 71 preterm neonates with PTX were included. 33 term neonates: 52% were treated expectantly, 36% with thoracic drainage and 12% with once-only pleural puncture (100% thoracic drainage after pleural puncture). 71 preterm neonates: 25% were treated expectantly, 52% with thoracic drainage and 23% with pleural puncture (63% thoracic drainage after pleural puncture). In CPAP-subgroup (n=64), term neonates were treated in 60% expectantly and in 40% with thoracic drain-age, preterm neonates in 33% expectantly, in 47% with thoracic drainage and in 20% with pleural puncture (50% thoracic drainage after pleural puncture). In CMV-subgroup (n=40), term neonates were treated in 44% expectantly, in 33% with thoracic drainage and in 22% with pleural puncture (100% thoracic drainage after pleural puncture), preterm neonates in 9% expectantly, in 64% with thoracic drainage and in 27% with pleural puncture (83% thoracic drain-age after pleural puncture).Present data show that expectant treatment is feasible. If invasive intervention is needed, once-only pleural puncture was not successful, as often thoracic drainage was necessary in addition.
authors.affiliation: Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Pocivalnik
authors.affiliation: Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Austria.
authors.forename: S V
authors.initials: SV
authors.lastname: Meheden
authors.affiliation: Universitätsklinik für Pädiatrie II (Neonatologie), Department für Kinder- und Jugendheilkunde, Medizinische Universität Innsbruck, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Griesmaier
authors.affiliation: Universitätsklinik für Pädiatrie II (Neonatologie), Department für Kinder- und Jugendheilkunde, Medizinische Universität Innsbruck, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Trawöger
authors.affiliation: Universitätsklinik für Pädiatrie II (Neonatologie), Department für Kinder- und Jugendheilkunde, Medizinische Universität Innsbruck, Austria.
authors.forename: U
authors.initials: U
authors.lastname: Kiechl-Kohlendorfer
authors.affiliation: Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Austria.
authors.forename: G
authors.initials: G
authors.lastname: Pichler
authors.affiliation: Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Reiterer
authors.affiliation: Abteilung für Neonatologie, Universitätsklinik für Kinder- und Jugendheilkunde, Medizinische Universität Graz, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Urlesberger
mesh_terms: D001317:Austria; D015505:Chest Tubes; D045422:Continuous Positive Airway Pressure; D004322:Drainage; D005240:Feasibility Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000628:therapy*; D008297:Male; D011030:Pneumothorax / Q000628:therapy*; D012121:Respiration, Artificial / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D057832:Watchful Waiting