Risk Factors of Pneumothorax in Infants with Hyaline Membrane Disease Receiving Intermittent Positive Positive Pressure Ventilation

The charts of 93 premature infants admitted to the neonatal intensive care unit from July 1983 to June 1985 were reviewed. Thirty-one cases with hyaline membrane disease receiving mechanical ventilation were identified; 16 were in the pneumothorax group and 15, in the control group. No significant difference was found in the sex, gestational age, birth weight, type of delivery, one minute and five minutes Apgar scores, inborn or outborn, time of intermittent positive pressure ventilation started, serum sodium level, grading of chest X-ray findings or lung volume between the two groups. There was also no significant, difference in the maximum ventilator settings or each parameter during the 24 hours Prior to the occurrence of pneumothorax. The finding of a lower highest PaCO2 in the study group pointed to the possibility of their more minute ventilation with a consequently greater chance of developing pneumothorax. The fluid intake during the second day of life and the day prior to pneumothorax were higher in the study group. It was concluded that fluid intake in the first few days of life should be restricted for infants receiving intermittent positive uentilation for hyaline membrane disease.