Pneumothorax as a cause of acute and recurrent neonatal hypoxia

In 191 children suffering from RDS treated by mechanical ventilation or CPAP + PEEP according to the same protocol the incidence of pneumothorax was determined with 23% (44 infants). Mean birthweight and mean gestational age were lower in infants who developed pneumothorax. Pneumothorax occurred more frequently in children with bad pre- and perinatal history. Children who developed pneumothorax had received a lower fluid intake than those without. Incidence varied with severity of RDS and intensity of respiratory assistance. We tried to asses the duration and severity of hypoxia by means of transcutaneous pO2 measure and arterial blood gas analyses. As fast diagnosis and therapy helps to shorten the duration of hypoxia, we listened up the most frequent alternations of vital signs associated with pneumothorax. We found cyanosis, changes in heart rate and respiratory rate, arterial blood pressure and decrease of paO2. Hints to avoid a pneumothorax are given.