Effectiveness of Targeted Oxygen Therapy for Non-Tension Pneumothorax in Full-Term Neonates

Abstract Background: Pneumothorax is deemed a medical exigency that bears substantial morbidity and mortality. Recently, efficacious management approaches have been reported for pneumothorax in hemodynamically stable neonates, involving the utilization of targeted oxygen to circumvent drainage and its associated complications. Objective: The purpose of this investigation was to assess the outcomes of oxygen therapy as a conservative approach to treating pneumothorax. Materials and Methods: A prospective interventional study was conducted over one year (2021-2022) at Tishreen University Hospital in Lattakia-Syria. The study enrolled full-term neonates diagnosed with non-tension unilateral pneumothorax, who were treated by administering oxygen via nasal cannula while closely monitoring for any indications of deterioration in the condition. The primary outcome measured was the time to resolution of pneumothorax through chest X-ray (CXR). The study was approved by Scientific Research Ethics Committee at Tishreen University on 1/6/2021. Written informed consent was obtained from the patients legal guardians. Results: Among the 23 neonates diagnosed with pneumothorax, 13 (56.5%) were male and 10 (43.5%) were female, exhibiting an average age and weight of 31.95±28.8 hours and 2803.04±336.01 g, respectively. Clinical signs manifested as tachypnea in all cases (100%), followed by intercostal retraction in 21 cases (91.3%) and subcostal retraction in 9 cases (39.1%). Pneumothorax was located on the right side for 11 cases and on the left side for 12 cases, with a mean volume of 10±4.4%. Consequently, there was a significant reduction in inspired oxygen concentration during follow-up periods(p:0.0001), resulting in an average resolution rate of approximately 17.70±8.1%/12 hour. observed across patients' data sets; complete resolution occurred within12 hours for11 cases(47 .8 %)and within 24 hours for the other cases. Conclusion: In conclusion, the present investigation has unearthed that resorting to oxygen therapy serves as a means of expediting the resolution of pneumothorax among neonates who are in stable condition.