Severe neonatal air leak syndrome – Question

Catarina Matos de Figueiredo, Jorge Abreu Ferreira, Ana Cristina Freitas, Ana Novo, Elisa Proença, Carmen Carvalho, Luísa Neiva Araújo

Abstract


Female neonate born at 29+4 gestational weeks by spontaneous vaginal delivery to a 37-year-old mother, with adequate prenatal surveillance and an uneventful pregnancy. Prophylactic antibiotics, tocolytic therapy and a single dose of steroids were given before birth. She was born with very low birth weight (1,440 grams) and with an Apgar score of 8 and 9 (first and fifth minutes, respectively). She was admitted in the Neonatal Intensive Care Unit and maintained on nCPAP due to mild respiratory distress. Within 4 hours she developed progressive respiratory insufficiency, without cardiovascular collapse.

Three chest X-rays are presented.

  1. What do you see in each chest radiograph?
  2. What is your diagnosis?
  3. Which procedures are recommended?

Keywords


air leak; pneumopericardium; pneumothorax; respiratory distress; prematurity

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