Thanks @spartacus007

it is a nice approach. 

is there is time frame for follow up shall i depend on clinical evaluation only

rule of serial x rays

the problem is tension pneumothorax can happen within seconds 

I don't have a good experience with needle thoracocentesis especially in ventilated babies

@M C Fadous Khalife I tend to agree, but in infants on non-invasive ventilation or in cases with no support at all but with resp distress and the x-ray shows pneumo, I have good experience.

In those "lighter" cases, needle thoracocentesis is def something reducing thoracic drains, in my experience

Check this ref out https://www.ncbi.nlm.nih.gov/pubmed/29799982