An abrupt increment in the respiratory rate is a sign of neonatal pneumothorax.
OBJECTIVE
The objective of the present study was to investigate the early clinical signs of neonatal pneumothorax.


METHODS
A case-control study at a level III referral center from 2006 to 2012 was conducted. For each neonate with pneumothorax (Group I), one control subject (Group II) was identified by selecting an infant born within the same week with a gestational age of ± 7 days and with a birth weight within 10% of the index case. The primary outcome was to investigate the clinical findings preceding the onset of pneumothorax. Secondary outcome was to assess the risk factors.


RESULTS
Of the 1375 infants admitted, 39 had a pneumothorax. Patients with pneumothorax showed significantly increased respiratory rates preceding the definitive diagnosis when compared with control patients (median: 16 (0-58) versus 4 (0-10); p < 0.001). An increase in the respiratory rate was found to be a significant clinical parameter preceding the diagnosis of pneumothorax (odds ratio (OR): 1.47, 95% confidence interval (CI): 1.12-2.14, p < 0.001; R(2) = 0.80). Sensitivity and specificity of this sign were found to be 77 and 90%, respectively.


CONCLUSIONS
An abrupt increase in the respiratory rate would be used as a reliable parameter to help determine an impending pneumothorax in neonates.
Department of Pediatrics, Division of Neonatology .
Mehmet Nevzat
MN
Cizmeci
Mehmet Kenan
MK
Kanburoglu
Ahmet Zulfikar
AZ
Akelma
Hilal
H
Andan
Kayihan
K
Akin
Mustafa Mansur
MM
Tatli
D001724:Birth Weight; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D007363:Intensive Care Units, Neonatal; D008297:Male; D011030:Pneumothorax / Q000151:congenital* / Q000175:diagnosis*; D056152:Respiratory Rate / Q000502:physiology*; D012189:Retrospective Studies; D015854:Up-Regulation
Critical care; neonatology; pneumothorax