Incidence of neonatal pneumothorax in rural tertiary care hospital in preHFOV era
Abstract
Pneumothorax is a critical condition characterized by the presence of air in the pleural space, which can lead to significant morbidity in neonates. This descriptive longitude+,inal observational study was conducted to assess the incidence of neonatal pneumothorax in a rural tertiary care hospital during the pre-High-Frequency Oscillation Ventilation (HFOV) era. The study involved all neonates admitted to inborn and outborn Neonatal Intensive Care Units (NICUs) from December 2020 to December 2022 at Dr. Balasaheb Vikhe Patil Rural Medical College, Loni. A total of 27,954 inborn neonates were delivered during the study period, of which 38 developed pneumothoraxes, resulting in a prevalence of 0.2%. Among the total admitted NICU patients (7,395), 60 neonates developed pneumothorax, corresponding to a prevalence of 0.8%. Risk factors such as respiratory distress syndrome (RDS), mechanical ventilation, and meconium aspiration syndrome were evaluated. The study found that early detection via bedside transillumination tests followed by chest X-rays facilitated timely diagnosis. Treatment options varied from observation for small pneumothoraxes to CPAP, needle aspiration, and chest tube insertion for more severe cases. The study's findings align with other research in the field but note lower incidence rates due to the limited study duration compared to others. The study concludes that neonatal pneumothorax remains a significant concern, with a call for future research involving larger sample sizes and advanced ventilation modalities such as HFOV to reduce the incidence and improve outcomes in rural settings. Limitations included the exclusive use of conventional mechanical ventilation during the study.
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