An abrupt increment in the respiratory rate is a sign of neonatal pneumothorax.

ABSTRACT

OBJECTIVE: The objective of the present study was to investigate the early clinical signs of neonatal pneumothorax. METHODS: A case-control study at a level III referral center from 2006 to 2012 was conducted. For each neonate with pneumothorax (Group I), one control subject (Group II) was identified by selecting an infant born within the same week with a gestational age of ± 7 days and with a birth weight within 10% of the index case. The primary outcome was to investigate the clinical findings preceding the onset of pneumothorax. Secondary outcome was to assess the risk factors. RESULTS: Of the 1375 infants admitted, 39 had a pneumothorax. Patients with pneumothorax showed significantly increased respiratory rates preceding the definitive diagnosis when compared with control patients (median 16 (0-58) versus 4 (0-10); p < 0.001). An increase in the respiratory rate was found to be a significant clinical parameter preceding the diagnosis of pneumothorax (odds ratio (OR) 1.47, 95% confidence interval (CI) 1.12-2.14, p < 0.001; R(2) = 0.80). Sensitivity and specificity of this sign were found to be 77 and 90%, respectively. CONCLUSION: An abrupt increase in the respiratory rate would be used as a reliable parameter to help determine an impending pneumothorax in neonates.