Novorođenački pneumotoraks

master's thesis

• Title (english): Neonatal pneumothorax
• Author: Antonia Gojanović
• Mentor: Stjepan Višnjić (mentor)
• Committee member: Goran Augustin (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Stjepan Višnjić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Jedan od sindroma istjecanja zraka iz pluća koji se javlja u novorođenčadi je pneumotoraks. Pneumotoraks čini nakupina zraka u pleuralnom prostoru, između parijetalne i visceralne pleure. Dijeli se na traumatski i spontani koji može biti primarni ili sekundarni.
Tenzijski pneumotoraks se razvija ako zrak kontinuirano tijekom udisaja ulazi u pleuralni prostor. Pneumotoraks se u novorođenačkom razdoblju javlja češće nego u bilo kojoj drugoj dobi. Zbog nerazvijenosti dišnog sustava u potpunosti češće se javlja u nedonoščadi. Rizični faktori za razvoj pneumotoraksa su mehanička ventilacija, respiratorni distres sindrom i sindrom aspiracije mekonija. Strategije koje smanjuju rizik nastanka pneumotoraksa su rana upotreba i više doza surfaktanta u usporedbi s kasnom upotrebom i manjim doza surfaktanta, sinkronizirana ventilacija u usporedbi s nesinkroniziranom ventilacijom. Većina
novorođenčadi nema nikakve simptome. Veliki i tenzijski pneumotoraks dovodi do pogoršanja respiratornog statusa. Novorođenče postane cijanotično, dispoično, oslabljenog disanja na strani pneumotoraksa. Dijagnoza se potvrđuje transiluminacijom, ultrazvukom i rendgenogramom torakalnih organa. Mali asimptomatski pneumotoraks povlači se spontano. Liječenje pneumotoraksa u novorođenčadi može biti opservacija, torakocenteza i drenaža pleuralne šupljine. U ovom radu napravljena je kratka presječna retrospektivna analiza 40 pacijenata koji su između siječnja 2010. i listopada 2019. liječeni zbog pneumotoraksa na Klinici za dječju kirurgiju, Klinike za dječje bolesti Zagreb. Podaci su prikupljeni pretraživanjem bolničkog informacijskog sustava i arhive povijesti bolesti.

Abstract (english)

One of the pulmonary air-leak syndromes that occurs in the newborn is pneumothorax. Pneumothorax is an accumulation of air in the pleural space, between parietal and visceral pleura. It is divided into traumatic and spontaneous which can be
primary and secondary. Tension pneumothorax develops if air continuously enters the pleural space during inhalation. Pneumothorax occurs more frequently in the neonatal period than at any other age. Due to the underdevelopment of the respiratory system, it occurs more often in preterm neonates. Risk factors for the development of pneumothorax are mechanical ventilation, respiratory distress syndrome, and meconium aspiration syndrome. Strategies that reduce the risk of pneumothorax are early use and higher doses of surfactant compared to delayed use and lower doses of surfactant, synchronized ventilation compared to non-synchronized ventilation. Most newborns do not have symptoms. Large and tension pneumothorax causes deterioration of respiratory status. The newborn becomes cyanotic, dyspneic, breath sounds decrease on the affected side. Diagnosis is confirmed by transillumination, ultrasound, and chest x-ray. Small asymptomatic pneumothorax resolves spontaneously. Treatment of pneumothorax in the newborn may be observation, needle thoracocentesis, and chest tube insertion. In this paper, a short retrospective analysis of 40 patients who were treated for
pneumothorax at the Department of Pediatric Surgery of the Children's Hospital Zagreb between January 2010 and October 2019 is made. The data was collected by searching the hospital information system and disease history archive.

• Keywords: novorođenče; nedonošče; pneumotoraks; mehanička ventilacija; respiratorni distres sindrom; sindrom aspiracije mekonija
• Keywords (english): neonate; preterm neonate; pneumothorax; mechanical ventilation; respiratory distress syndrome; meconium aspiration syndrome
• Language: croatian
• URN:NBN: urn:nbn:hr:105:236501
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-03-30 09:20:13