Pneumothorax and Pneumomediastinum in Infants With ldiopathic Respiratory Distress Syndrome Receiving Continuous Positive Airway Pressure

PEDIATRICS ◽  
1975 ◽  
Vol 55 (4) ◽  
pp. 493-496
Author(s):  
Robert T. Hall ◽  
Philip G. Rhodes
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Oxygen Concentration ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Underlying Mechanism ◽  
Treated Group ◽  
Controlled Study ◽  
Idiopathic Respiratory Distress Syndrome ◽  
Inspired Oxygen

A review of infants with idiopathic respiratory distress syndrome developing pneumomediastinum and pneumothorax reveals (1) an incidence of 20% in patients receiving CPAP with an 11% incidence in comparable infants not receiving this mode of therapy; (2) in the CAPA-treated group the occurrence was at a stage in the illness when the inspired oxygen concentration was being lowered and when ventilation was stable; (3) the inspired oxygen concentration in the CPAP group at the time of the PM and/or PT was 52% (± S.D. 15%) at a mean age of 33 hours (± S.D. 23 hr). These observations suggest that distending airway pressure creates excessive alveolar distention as an underlying mechanism of the air leak. It is recommended that distending airway pressure be lowered prior to achieving an inspired oxygen concentration of 60%. A controlled study is in progress to delineate the optimum distending airway pressures at specific inspired oxygen concentrations in order to reduce the incidence of alveolar rupture to a minimum.

OBSERVATIONS ON THE RELATIONSHIP BETWEEN DURATION OF RUPTURE OF THE MEMBRANES AND THE DEVELOPMENT OF IDIOPATHIC RESPIRATORY DISTRESS SYNDROME

PEDIATRICS ◽  
1973 ◽  
Vol 52 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Jing Ja Yoon ◽  
Rita G. Harper
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Maternal Diabetes ◽  
Fetal Asphyxia ◽  
History Of ◽  
Idiopathic Respiratory Distress Syndrome ◽  
The Relationship

Retrospective analysis of 211 premature infants between 1,001 and 2,165 gm at birth revealed a decreased incidence of idiopathic respiratory distress syndrome in infants with rupture of the membranes more than 24 hours prior to delivery. Infants with factors which are known to predispose to idiopathic respiratory distress syndrome (maternal hemorrhage, maternal diabetes, fetal asphyxia, twin B, history of a sibling with idiopathic respiratory distress syndrome and cesarean section) were then eliminated. One hundred and twenty infants remained. Infants with rupture of the membranes more than 24 hours prior to delivery had a significantly lower incidence of idiopathic respiratory distress syndrome when compared with infants with rupture of the membranes less than 12 hours prior to delivery (P<0.05). From this study it appears that rupture of the membranes for more than 24 hours prior to delivery protects against the development of idiopathic respiratory distress syndrome.

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