Pneumothorax is a lung disorder in which air in the lungs leaks out through holes in the lung tissue into the spaces outside the lung airways. Pneumothorax is one type of lung disorders called air leak syndrome. A baby can have more than one form of air leak. Types of air leaks include the following:
Air leaks may occur suddenly or may develop gradually. The degree of illness depends on the location of the leak, how quickly the leak occurs, and the amount of air.
Air leaks occur when the alveoli (tiny air sacs) become overdistended and burst. Pressure of the air delivered by mechanical ventilators (breathing machines) is the most common cause. Meconium aspiration (inhalation of the first stools passed in utero) can also trap air and lead to overdistention (the lungs expand too much) and air leaks. Air leaks often occur in the first 24 to 36 hours when lung disease is at its peak. Some otherwise healthy babies can develop a "spontaneous" air leak that does not cause symptoms or distress.
The following babies are most at risk for pneumothorax:
The following are the most common symptoms of pneumothorax. However, each baby may experience symptoms differently. Symptoms may include:
The symptoms of pneumothorax may resemble other conditions or medical problems. Always consult your baby's doctor for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for pneumothorax may include:
Specific treatment for pneumothorax and air leak syndrome will be determined by your baby's doctor based on:
Treatment for pneumothorax may include:
Spontaneous air leaks that do not cause symptoms or distress may get better on their own without treatment. As the leak seals over, air is absorbed into the body.
There are no specific treatments for pneumomediastinum and pulmonary interstitial emphysema (PIE), as these air leaks are in spaces that cannot be treated with chest tubes. High frequency ventilation, a special kind of mechanical ventilation, is sometimes used for babies with PIE.
Despite careful regulation of the air pressure and the settings on mechanical ventilators, air leaks can still occur. Your baby's doctor and other health care providers in the newborn intensive care unit (NICU) will watch your baby carefully for signs of air leak so that treatment can be started as quickly as possible.
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