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Newborn and Infant Care

Lungs: pneumothorax in the newborn

04/23/1998

Question:

Diagnosis of smallhole in a lung on a newborn baby?

Answer:

A hole in the lung is referred to as a pneumothorax, which means air in the chest outside the lungs. Pneumothorax may occur spontaneously, as a result of mechanical ventilation, or as a complication of certain procedures.

Spontaneous pneumothorax generally occurs during the first few breaths post-delivery and is asymptomatic. Symptoms of respiratory distress such as rapid breathing, nasal flaring, grunting with expiration, and cyanosis (blue coloration of the skin) may be present in some babies, but these symptoms usually respond to temporary oxygen supplementation with no long term consequences.

Pneumothorax that occurs as a result of mechanical ventilation is a more significant problem because air that escapes from the lung continues to accumulate and puts tension (pressure) on the lung, making it more difficult for the baby to breathe with each breath. These tension pneumothoraces must be treated rapidly to stabilize the baby's breathing. Tension pneumotharaces occur in babies with other underlying lung problems.

A pneumothorax caused by other procedures is rare, but can occur in babies with indwelling endotracheal tubes (breathing tubes in the baby's windpipe)during suctioning to remove secretions or sometimes are necessary during cardiopulmonary (heart and lungs)surgery.

Answered by: Judy Wright Lott, RNC, NNP, DSN Associate Professor of Nursing College of Nursing and Health University of Cincinnati

References: Korones, S.B.(1996). Complications:Bronchopulmonary dysplasia, air leak syndromes, and retinopathy of prematurity (pp. 327-352). In Jay P. Goldsmith & Edward Karotkin (Eds.). Assisted Ventilation of the Neonate. WB Saunders Co: Philadelphia.

Related Resources:

Pneumothorax Information

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Response by:

Tina   Weitkamp, RNC, MSN Tina Weitkamp, RNC, MSN
Associate Professor of Clinical Nursing
College of Nursing
University of Cincinnati