Causes and Symptoms of Pneumothorax In Newborn Infants

Pneumothorax is collapse of lung caused due to leakage and accumulation of air in the space between chest wall and lung. Due to collection of air the lung gets compressed and loses its elasticity leading to its collapse. Pneumothorax in newborn is a life threatening condition. It usually occurs in prematurely born babies due to lack of lung surfactant.

Other causes can be aspiration of meconium, use of ventilator for breathing difficulty. The symptoms of pneumothorax in neonates include respiratory distress, cyanosis, irritation and restlessness. Diagnosis is usually made with the help of X-ray and physical examination. Treatment consists of insertion of a thin tube or a needle in the chest between the lung and chest wall to remove the air. If detected early and given prompt treatment the prognosis is good.

Causes

Pneumothorax as mentioned earlier is collapse of lung or part of lung due to leakage and accumulation of air in the space between the chest wall and the lung. Pneumothorax can occur in anyone including newborn. However, the cause may vary.

At least 1 to 2 percent of newborn may develop pneumothorax. The main reason for its occurrence in neonates is as follows:

• Pneumothorax is mainly observed in premature newborns. Lack of surfactants is the primary cause in newborns. Surfactants are important to keep the tiny air sacs remain open in newborn. Its presence prevents collapse of air sacs.
• Keeping the baby on ventilator can sometimes cause increase in pressure within the lungs. The air sacs when filled with too much of air from the ventilator may burst and result in collapse of lung.
• Aspiration of meconium during delivery is one of the causes. Meconium is feces of the fetus.

Pneumothorax in neonates is more common in male child than girl child. The risk factor in premature babies increases because their lungs are weak. They often suffer from respiratory distress syndrome.

Signs and Symptoms

Pneumothorax in infants and newborn as a result of collapse of lung is manifested with several clinical features. They are as follows:

• Distressed breathing
• Rapid breathing
• Increased irritability
• Restlessness and cries constantly.
• Weakness due to rapid breathing.
• The sides of nostril flare
• Cyanosis which means blue discoloration of skin, nails, lip and tongue. This occurs due to lack of oxygen in circulation as a result of lung collapse.

Diagnosis and Treatment

Abnormal breathing and other clinical features of the newborn may indicate some trouble. On sensing something wrong after physical examination of the baby the doctor may recommend certain test to rule out a lung problem, mainly pneumothorax. Certain tests such as X-ray of chest, blood test, and transillumination test will be useful in detecting pneumothorax.

Once pneumothorax in newborn is diagnosed the immediate treatment is to monitor the child if there is no breathing distress. In such cases the pneumothorax may resolve on its own without any specific intervention. However, close monitoring is required to prevent complications. In case if the child is having distressed breathing with cyanosis etc, treatment consists of placing a tube or needle in the space between the chest wall and the lungs to remove accumulated air. The procedure is called thoracotomy. In case of breathing difficulty oxygen is given to the child.