What causes a pneumothorax?
A pneumothorax can occur on it's own as a result of breathing assistance with the ventilator and rarely, as a complication from some procedures. A spontaneous pneumothorax usually happens the first few breaths after birth and the baby may not show any symptoms at all. Pneumothoraces that occur during ventilatory assistance are due to the high pressure that is needed to open the baby's lungs. Babies with respiratory distress and premature babies are at an increased risk for a pneumothorax.
What are the symptoms?
- Retractions: the chest sinks in and the ribs show when the baby breathes.
- Flaring of the nostrils
- Dusky or bluish color of the skin (cyanosis)
- Breathing at a fast rate (tachypnea)
To check for a pneumothorax a bright light is placed against the baby's chest. Pockets of air can be seen as light areas. A chest x-ray confirms the diagnosis.
What is the treatment?
Some pneumothoraces do not cause problems and no treatment is necessary. The baby will continue to be monitored so that if symptoms occur treatment will be prompt.
Sometimes a pneumothorax can be treated by giving the baby oxygen by oxyhood. A plastic dome fits loosely around the baby's head and oxygen helps the air in the baby's chest be absorbed by the body; this is called a nitrogen washout.
If the baby has a pneumothorax that causes them to have respiratory problems, a chest tube will be inserted. A small incision is made in the baby's chest. A tube is inserted and placed between the baby's lung and the chest wall; the tube will remove the air in the chest. This tube is usually left in place for a few days. When a chest tube is in place the baby is moved as little as possible. The chest tube is removed when the lung heals; a small stitch or gauze is then placed over the area. A small scar can be expected at the site where the chest tube was placed.