January 29, 201015 yr This is about a 2 days old baby 36weeks,delivered by C section. Mother with urinary infection. Dx with Pneumonia. Developed respiratory distress,managed with Survanta plus nasal CPAP. X rays with Pneumothorax.Evacuated by needle puncture .(32cc of air ). Persistent distress,intubated and with mechanical ventilation improved. New X rays with 30 % ?? pneumothorax .Attending decided not to place chest tube. Big controversy..I would like to hear your opinion in this case. Regards .
January 30, 201015 yr Could you upload an x-ray? It is hard to say but it seems plausible that the pneumo contributes to the respiratory distress. You could try to evacuate the pneumo once again with a needle. If air returns on x-ray, you def have a leak which probably needs to heal under drainage.
January 31, 201015 yr comment_2874 I would like to see CXR too.I have experience for pneumothorax and do not on chest tube by using CPAP instead of ventilator ith 100% Oxygen. Uraiwan Send Sticky Note
February 1, 201015 yr Author Dear colleagues .I'm sorry ,but I can't upload the X rays. In the middle of this case we experienced problems with Radiology.Poor quality films. Case update: baby doing better,no pneumothorax today.Ready for CPAP.Thanks for your opinion.
February 1, 201015 yr Happy ending then! Glad to hear that you managed your case with a conservative strategy. General comment: aggressive active strategies are is always easy, sometimes they are not necessary.
February 21, 201015 yr comment_2961 This is about a 2 days old baby 36weeks,delivered by C section. Mother with urinary infection. Dx with Pneumonia. Developed respiratory distress,managed with Survanta plus nasal CPAP. X rays with Pneumothorax.Evacuated by needle puncture .(32cc of air ). Persistent distress,intubated and with mechanical ventilation improved. New X rays with 30 % ?? pneumothorax .Attending decided not to place chest tube. Big controversy..I would like to hear your opinion in this case. Regards . Send Sticky Note
February 23, 201015 yr comment_2965 We can extubate the patient if patient can on low CPAP and can breath well, not distress with high FiO2. uraiwn Send Sticky Note
May 31, 201015 yr The CPAP nasal are contribuate to product the pneumothorax, Intubated favorise the pneumothorax. FiO2 at 100% is indicated. If the pneumothorax is installeted with méchanical ventilation + PIP hight 25, place tube is indicated.
June 1, 201015 yr FiO2 at 100% is indicated. . 100% FiO2 is no longer recommended Sola A, Saldeño YP, Favareto V. Clinical practices in neonatal oxygenation: where have we failed? What can we do? J Perinatol. 2008 May;28 Suppl 1:S28-34. Review. PubMed PMID: 18446174. LINK to DOWNLOAD
June 7, 201015 yr 100% FiO2 is no longer recommended is recommended for full term newborn during short period
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