Incidence and Management of Neonatal Pneumothorax in a 10-Hospital Regional Perinatal Network in Switzerland: A Retrospective Observational Study
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| Název: | Incidence and Management of Neonatal Pneumothorax in a 10-Hospital Regional Perinatal Network in Switzerland: A Retrospective Observational Study |
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| Autoři: | Baudat-Nguyen, J., Schneider, J., Roth-Kleiner, M., Barrielle, L., Diebold, P., Duvoisin, G., El Faleh, I., Grupe, S., Huber, B.M., Morel, A.S., Paccaud, Y., Torregrossa, A., Younes, D., Tolsa, J.F., Truttmann, A.C. |
| Zdroj: | Am J Perinatol American journal of perinatology, vol. 41, no. S 01, pp. e3305-e3312 |
| Informace o vydavateli: | Georg Thieme Verlag KG, 2023. |
| Rok vydání: | 2023 |
| Témata: | Male, Incidence, Infant, Newborn, Pneumothorax, Length of Stay, Conservative Treatment, 03 medical and health sciences, 0302 clinical medicine, Humans, Pneumothorax/therapy, Pneumothorax/epidemiology, Retrospective Studies, Female, Switzerland/epidemiology, Drainage/methods, Length of Stay/statistics & numerical data, Chest Tubes, Conservative Treatment/methods, Risk Factors, Drainage, Switzerland |
| Popis: | Objective Pneumothorax (PTX) is a potentially life-threatening condition that affects neonates, with an incidence of 0.05 to 2%. Its management includes conservative treatment, chest tube (CT) drainage, and needle aspiration (NA). Aims were to evaluate the incidence of PTX in a 10-hospital perinatal network, its clinical characteristics and risk factors, and to compare the different treatment options. Study Design All neonates diagnosed with PTX and hospitalized in the network were included in this retrospective observational trial over a period of 30 months. Primary outcome was the incidence of PTX. Secondary outcomes were the treatment modality, the length of stay (LOS), and the number of chest X-rays. Results Among the 173 neonates included, the overall incidence of PTX was 0.56 per 100 births with a large range among the hospitals (0.12–1.24). Thirty-nine percent of pneumothoraces were treated conservatively, 41% by CT drainage, 13% by NA, and 7% by combined treatment. Failure rate was higher for NA (37%) than for CT drainage (9%). However, the number of X-rays was lower for patients treated by NA, with a median of 6 (interquartile range [IQR] 4–6.25), than by CT drainage, with a median of 9 (IQR 7–12). LOS was shorter for NA than for CT drainage, with a median of 2 (IQR 1–4.25) and 6 days (IQR 3–15), respectively. Complications, including apnea and urinary retention, occurred in 28% of patients managed with CT drainage, whereas none was observed with NA. Conclusion High variability of PTX incidence was observed among the hospitals within the network, but these values correspond to the literature. NA showed to reduce the number of X-rays, the LOS, and complications compared with CT drainage, but it carries a high failure rate. This study helped provide a new decisional management algorithm to harmonize and improve PTX treatment within our network. Key Points |
| Druh dokumentu: | Article Other literature type |
| Popis souboru: | application/pdf |
| Jazyk: | English |
| ISSN: | 1098-8785 0735-1631 |
| DOI: | 10.1055/s-0043-1777861 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/38154466 http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_7ECE7BB537577 https://serval.unil.ch/resource/serval:BIB_7ECE7BB53757.P001/REF.pdf https://serval.unil.ch/notice/serval:BIB_7ECE7BB53757 |
| Rights: | CC BY NC ND URL: http://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited. |
| Přístupové číslo: | edsair.doi.dedup.....41163f028fffb8f2bd0600a49e99792b |
| Databáze: | OpenAIRE |
Nájsť tento článok vo Web of Science | Abstrakt: | Objective Pneumothorax (PTX) is a potentially life-threatening condition that affects neonates, with an incidence of 0.05 to 2%. Its management includes conservative treatment, chest tube (CT) drainage, and needle aspiration (NA). Aims were to evaluate the incidence of PTX in a 10-hospital perinatal network, its clinical characteristics and risk factors, and to compare the different treatment options. Study Design All neonates diagnosed with PTX and hospitalized in the network were included in this retrospective observational trial over a period of 30 months. Primary outcome was the incidence of PTX. Secondary outcomes were the treatment modality, the length of stay (LOS), and the number of chest X-rays. Results Among the 173 neonates included, the overall incidence of PTX was 0.56 per 100 births with a large range among the hospitals (0.12–1.24). Thirty-nine percent of pneumothoraces were treated conservatively, 41% by CT drainage, 13% by NA, and 7% by combined treatment. Failure rate was higher for NA (37%) than for CT drainage (9%). However, the number of X-rays was lower for patients treated by NA, with a median of 6 (interquartile range [IQR] 4–6.25), than by CT drainage, with a median of 9 (IQR 7–12). LOS was shorter for NA than for CT drainage, with a median of 2 (IQR 1–4.25) and 6 days (IQR 3–15), respectively. Complications, including apnea and urinary retention, occurred in 28% of patients managed with CT drainage, whereas none was observed with NA. Conclusion High variability of PTX incidence was observed among the hospitals within the network, but these values correspond to the literature. NA showed to reduce the number of X-rays, the LOS, and complications compared with CT drainage, but it carries a high failure rate. This study helped provide a new decisional management algorithm to harmonize and improve PTX treatment within our network. Key Points |
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| ISSN: | 10988785 07351631 |
| DOI: | 10.1055/s-0043-1777861 |