Respiratory distress syndrome with pneumothorax

Case contributed by Sally Ayesa

Presentation

Premature neonate. Increased work of breathing and difficulty ventilating.

Patient Data

Age: 2 days

The lung volumes are small. There is diffuse granular opacification throughout the lungs without dense consolidation. 

There is a small left pneumothorax, seen best in the lateral mid to lower zone. No evidence of tension or pneumomediastinum. 

The tip of right PICC line projects over the left apex, most likely within the subclavian vein. The tip of the feeding tube projects over the proximal stomach. 

Case Discussion

Premature neonates are at risk of developing respiratory distress syndrome (also known as hyaline membrane disease) secondary to insufficient production of surfactant in the lungs.

Assisted ventilation can be difficult in these cases. There is an increased risk of barotrauma which may manifest as pneumothorax, pneumomediastinum or pulmonary interstitial emphysema. 

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