Pneumothorax in Newborns: Needle, Less Damage Done?

摘要

The association between pneumothorax – a collection of air in the pleural space – and respiratory distress was described almost 200 years ago. Pneumothorax may itself be the primary cause or may occur as a consequence of other causes of respiratory distress. Distressingly, it may also be a consequence of treatment given for respiratory distress. It may present in acutely, sometimes critically, ill patients, and merit such urgent treatment that students are told that the chest X-ray (CXR) showing a tension pneumothorax is “the film that should never be seen”. Treatment options include watchful waiting for spontaneous resolution, aspiration of air through a needle temporarily inserted between the ribs (needle aspiration), and insertion of a catheter between the ribs that is left in situ for continued drainage (chest drain). Needle aspiration is recommended by the British Thoracic Society as the first line treatment of symptomatic spontaneous pneumothorax in adults.