PEDIATRICS Vol. 58 No. 2 August 1976, pp. 177-183
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ogata, E. S.
Right arrow Articles by Tooley, W. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ogata, E. S.
Right arrow Articles by Tooley, W. H.

Pneumothorax in the Respiratory Distress Syndrome: Incidence and Effect on Vital Signs, Blood Gases, and pH

Edward S. Ogata M.D.1, George A. Gregory M.D.1, Joseph A. Kitterman M.D.1, Roderic H. Phibbs M.D.1, and William H. Tooley M.D.1

1 Cardiovascular Research Institute and the Departments of Pediatrics and Anesthesia, University of California, San Francisco

We determined the incidence of pneumothorax in 295 infants (mean birthweight, 1,917 gm) with the respiratory distress syndrome (RDS) treated according to the same protocol. Fifty-five infants (mean birthweight, 1,594 gm) developed pneumothorax (incidence, 19%); incidence varied with severity of RDS and intensity of respiratory assistance. Pneumothorax occurred in 3.5% (2 of 58) of infants who received no assisted ventilation and in 11% (14 of 124) of infants who received continuous positive airway pressure (CPAP) as the only form of assisted ventilation; the difference between these two groups is not significant. Forty-nine infants initially treated with CPAP later required mechanical ventilation with positive end-expiratory pressure (PEEP). Pneumothorax occurred in 12 of the 49 (24%) and in 21 of 64 (33%) of those infants initially treated with PEEP; the incidence of pneumothorax for both these groups was significantly higher than for those treated with no assisted ventilation or CPAP only.

To assess the value of frequent measurement of vital signs, blood gas tensions, and pH in the recognition of pneumothorax, we analyzed these variables by the cumulative sum statistical technique. We noted the following significant changes associated with pneumothorax: arterial blood pressure, heart rate, and respiratory rate decreased in 77% of cases; pulse pressure narrowed in 51% of cases; Po2 decreased in 17 of 20 cases in which ventilatory settings were constant for at least three hours prior to pneumothorax. However, pH and PCO2 showed no consistent changes. Frequent measurements of vital signs and Po2 aid in the early diagnosis of pneumothorax.

Submitted on June 6, 1975
Accepted on December 17, 1975




This article has been cited by other articles:


Home page
 PediatricsHome page
I. Litmanovitz and W. A. Carlo
Expectant Management of Pneumothorax in Ventilated Neonates
Pediatrics, November 1, 2008; 122(5): e975 - e979.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
A. L. Jung, J. Nelson, M. B. Jenkins, and W. A. Hodson
Clinical Evaluation of a New Chest Tube Used in Neonates
Clinical Pediatrics, February 1, 1991; 30(2): 85 - 87.
[Abstract] [PDF]

Home page
 Arch SurgHome page
C. D. Goldman, S. H. Blocker, J. L. Ternberg, and E. C. Crouch
Management of Experimental Pneumothorax in Weanling Rabbits With the Use of Fibrin Glue Sclerosant
Arch Surg, May 1, 1986; 121(5): 565 - 568.
[Abstract] [PDF]