Pneumothorax in Infants

Pneumothorax in Infants

Articlepneumothoraxininfants
Healthy Lungs
Kids' Zone
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Contributed byKrish Tangella MD, MBADec 17, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Air Leak Syndrome in Infants
  • Infantile Pneumothorax
  • Pneumothorax in Newborns 

What is Pneumothorax in Infants? (Definition/Background Information)

  • Pneumothorax is the accumulation of air or gas particularly in the space found between the chest wall and lung. The accumulation of air forces the lung to lose its elasticity and therefore collapse
  • Pneumothorax in Infants occurs more often in prematurely born infants. Surfactants in the lungs, which are necessary to keep the air sacs open, do not have time to develop in prematurely born babies, and is considered the leading cause of Pneumothorax in Infants
  • Additionally, aspiration of meconium during birthing or ventilator use for breathing difficulties in infants can also potentially cause Pneumothorax in Infants
  • Some common symptoms associated with Pneumothorax in infants include breathing difficulties, restlessness, cyanosis, and breathing distress. A diagnosis of Pneumothorax-Infants is generally made by physical exam and chest X-ray
  • Some potential complications of Pneumothorax in Infants include a drop in blood pressure and increased air in one lung, putting pressure on the other lung and heart
  • When a baby presents with signs and symptoms, a thin tube or needle is placed in the chest to remove the air. Monitoring prematurely born babies for any sign of respiratory distress is an effective method of preventing pneumothorax in them
  • The prognosis for Pneumothorax in Infants is considered to be good with appropriate and timely treatment of the condition 

Pneumothorax can be classified as the following types:

  • Primary Spontaneous Pneumothorax, which can occur without a past medical history of a lung disease
  • Secondary Spontaneous Pneumothorax occurring in an individual with a known history of either acute or chronic lung damage
  • Traumatic Pneumothorax caused by a penetrating wound to the chest wall
  • Iatrogenic Pneumothorax caused in a healthcare setting due to surgical procedures, such as central line placement and use of mechanical ventilation

Who gets Pneumothorax in Infants? (Age and Sex Distribution)

  • This form of pneumothorax is found among infants. Pneumothorax in Infants is generally observed in preterm babies
  • The condition is more common among baby boys compared to baby girls
  • Pneumothorax in Newborns is observed worldwide and all racial and ethnic groups may be affected 

What are the Risk Factors for Pneumothorax in Infants? (Predisposing Factors)

The risk factors associated with Pneumothorax in Infants include:

  • Preterm delivery that is greatly associated with respiratory distress syndrome (difficulty breathing in neonates due to immature lungs)
  • Newborn babies with congenital lung disorders (which occurs during fetal development)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Pneumothorax in Infants? (Etiology)

Some causes of Infantile Pneumothorax may include:

  • Premature birth of an infant: Premature births do not allow an important factor called surfactants to develop. Surfactants are very important for keeping the air sacs within the lungs open, and preventing them from collapsing
  • Placing the baby on a breathing ventilator: This procedure can cause increased pressure within the lungs. Too much pressure can result in the air sacs to burst, causing them to collapse and result in pneumothorax
  • Meconium aspiration syndrome: In this syndrome, there is aspiration of meconium during childbirth. Meconium is the feces from the first bowel movement of the baby 

What are the Signs and Symptoms of Pneumothorax in Infants?

The signs and symptoms associated with Pneumothorax in Infants may include:

  • Difficulty breathing
  • Breathing distress with faster breathing: Caregivers will notice severe distress in the baby when he/she is breathing
  • Abnormal noises upon breathing
  • Flaring of nostrils
  • Weakness and tiredness
  • Cyanosis/bluish discoloration of skin: This results from a lack of sufficient oxygen being supplied to the body 

How is Pneumothorax in Infants Diagnosed?

A diagnosis of Pneumothorax in Infants can involve:

  • A healthcare provider might diagnose the condition by observing the baby, as Pneumothorax in Infants is easily noticeable with breathing problems and normally present with abnormal sounds
  • During a physical examination, the pediatrician may hear abnormal sounds in the lungs, through a stethoscope
  • Arterial blood gas analysis
  • A chest X-ray can help provide a definitive diagnosis
  • Transillumination test: A procedure which uses a light probe applied along the baby’s chest; the affected areas light up while in a darkened room 

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Pneumothorax in Infants?

The potential complications associated with Pneumothorax in Infants may include:

  • Hypotension (a drop in blood pressure)
  • Tension pneumothorax: Air build up in the lung puts pressure on the heart and on the other lung. This is a medical emergency and requires urgent treatment

How is Pneumothorax in Infants Treated?

Babies with no signs and symptoms generally do not require any treatment. Hence, Pneumothorax in Infants gets better on its own.

  • In case a baby shows breathing distress, a thin tube or needle is placed in the chest to remove the air (a procedure known as thoracotomy)
  • Supplemental oxygen may be given in cases of decreased oxygenation and poor breathing 

How can Pneumothorax in Infants be Prevented?

Monitoring premature infants for signs of respiratory distress is considered a key preventive method for Pneumothorax in Infants. 

What is the Prognosis of Pneumothorax in Infants? (Outcomes/Resolutions)

  • The prognosis for Pneumothorax in Infants is good, if the air that is accumulated is removed by a needle or catheter
  • In mild cases, the prognosis is excellent since pneumothorax may get better without any treatment measures 

Additional and Relevant Useful Information for Pneumothorax in Infants:

The following DoveMed website link is a useful resource for additional information:

https://www.dovemed.com/healthy-living/healthy-lungs/

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Krish Tangella MD, MBA picture
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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