Prevalence and Risk Factors of Pneumothorax among Patients in Pediatric Intensive Care Unit

Document Type : Original Article

Authors

Department of Pediatric Medicine, Faculty of Medicine, Tanta University, Egypt

Abstract

Background: Pneumothorax should be considered a medical emergency and requires a high index of suspicion and prompt recognition and intervention. Aim of the work: was to study the prevalence and risk factors of pneumothorax among children in Tanta PICU. Subjects and Methods: Sixty pediatric patients aged from 2 to 180 months (29 males and 31 females) admitted to PICU, Tanta University Hospital and were divided into 3 groups: Group 1: 20 patients on PCMV. Group II: 20 patients on HFOV: Group III: 20 non-ventilated patients. Each group was further divided into two subgroups: Subgroup I (SGI): without pneumothorax, Subgroup II (SGII): with pneumothorax. All patients were subjected to scoring systems for Pediatric Risk for Mortality (PRISM III) and Sequential Organ Failure Assessment (SOFA). They were also monitored for [pulse oximetry, blood pressure, oxygenation index, oxygenation saturation index, lung mechanics (compliance and resistance), ventilation parameters (HFOV and P-CMV) and trans-esophageal Doppler]. Results: Incidence of pneumothorax in patients on P-CMV is higher than who on HFOV and non- ventilated group. The significant risk factors of pneumothorax were HR, RR, pH, PCO2, HCO3, PaO2, SaO2, OI, MAP, FIO2, PIP, CO, CI, SVRI, SOFA and PRISM III score. X-ray showed equal results to CT chest in the diagnosis of pneumothorax without the disadvantage of exposure to high radiation accompanied the use of CT. Conclusion: Pneumothorax in P-CMV patients occur with higher ventilatory settings. Most cases of pneumothorax have underlying lung disease as pneumonia and ARDS. Mortality rate is higher among patients with pneumothorax.

Keywords

The Egyptian Journal of Hospital Medicine
Volume 76, Issue 6
July 2019
Pages 4417-4426

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