PEDIATRICS Vol. 24 No. 6 December 1959, pp. 996-1004
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RECOGNITION OF SPONTANEOUS PNEUMOTHORAX IN PREMATURE INFANTS

Lula O. Lubchenco M.D.1

1 Premature Infant Center, Department of Pediatrics, University of Colorado Medical Center

An analysis of the clinical records of 27 infants who developed spontaneous pneumothorax in the neonatal period is presented; 17 (63%) were premature infants.

The age at onset of the disease varied with the birth weight. The infants with birth weights of 1,500 grams or less averaged 24 days of age at the onset of spontaneous pneumothorax, and the full-term infants developed the disease in the immediate newborn period.

The diagnosis of spontaneous pneumothorax was suspected when symptoms of respiratory distress alternated with unusual activity, with an increase of symptoms when the infant was fed or removed from oxygen.

The immature infant showed cyanosis or apneic spells, alternating with alertness or apparent hunger. The more mature infant manifested greater respiratory distress and greater activity. The activity assumed the form of irritability, restlessness and, at times, opisthotonus. These symptoms were considered to be due to a persistent lowgrade hypoxia caused by the pneumothorax rather than being manifestations of a vigorous, healthy infant. Signs of infection were minimal or absent. The importance of roentgenograms in establishing the diagnosis is emphasized.

Treatment should include relief of hypoxia by administration of oxygen in low concentration and prevention of acute respiratory embarrassment due to distention of the stomach by feedings. Removal of air from the pneumothorax or pneumomediastinum is necessary in severe cases.

Submitted on May 2, 1959
Accepted on May 29, 1959




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E. A. Magill and C. H.M. Walker
Intracath Treatment of Tension Pneumothorax in the Neonate: "Surgical" or "Medical" Management?
Clinical Pediatrics, November 1, 1972; 11(11): 648 - 653.
[Abstract] [PDF]