Outcomes of spontaneous pneumothorax in neonates: treatments vs. expectant management.

BACKGROUND

Neonatal pneumothorax is dependent on severity of symptoms and leak size. Treatment of Pneumothorax with Nitrogen washout is controversial.

OBJECTIVE

To compare outcomes of neonates treated for spontaneous pneumothorax (SP) compared with those managed expectantly.

METHODS

A retrospective review of medical records of neonates (≥34weeks) diagnosed with SP born between 2011 and 2021. Neonatal characteristics and outcomes were compared between neonates treated for SP with either targeted oxygen therapy (to stabilize saturation ≥93%) or nitrogen washout and those under expectant management.

RESULTS

Among neonates with respiratory distress and desaturation (n = 64), nitrogen washout reduced median time to resolution compared to targeted oxygen therapy (31 [12-67] vs 81 [31.8-123.5] hours, p = 0.012). Expectantly managed neonates with distress (n = 87) experienced delayed feeding initiation, while time to resolution and hospital stay were similar.

CONCLUSION

Nitrogen washout is superior to targeted oxygen therapy in time to resolution in infants presenting with respiratory distress and desaturation.