Pneumothorax in Neonates on Continuous Positive Airway Pressure Support: Prevalence, Risk Factors and Outcome

Background: Pneumothorax (PN)is a life threatening condition that occurs more commonly in the neonatal period than any other period of life. Objective: The aim of the study is to evaluate the prevalence of pneumothorax in neonates receiving continuous positive airway pressure (CPAP) support, to asses risk factors and to describe management and outcome. Methods and Materials: This is a retrospective study including 477 neonates with a gestational age between 32-42 weeks, admitted to the neonatal intensive care unit (NICU) at Al-Numan Teaching Hospital from January 2019 to December 2020. Patients were divided into 2 groups, those that needed continuous positive airway pressure support and those that didn?t, information was taken from their medical records regarding gender, gestational age, type of delivery, clinical condition, management and outcome. Results: From the 477 patients, 11 patients developed pneumothorax (2.3%). 9 patients with CPAP support (1.8%) and 2 without CPAP support (0.4%). (2.4%) of patients on CPAP support developed pneumothorax, while (1.8%) of patients without CPAP support developed pneumothorax. Regarding patients on CPAP support who developed pneumothorax significant risk factors included prematurity (66.6%), C/S delivery (66.6%), respiratory distress syndrome (RDS) 55.5% and transient tachypnea of newborn (TTN). Drainage by chest tube was needed in 8 patients (88.8%) and one patient died (11.1%). Conclusion: Pneumothorax is a potential risk for neonates admitted to the NICU with a slight increase in prevalence in those needing CPAP support. Good observation, prediction of risk factors (prematurity, C/S delivery, RDS and TTN) and proper management are key factors for good outcome.