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Peumomediastinum in the Newborn.

Journal of the Korean Pediatric Society 1985;28(3):217-224.
Published online March 31, 1985.
Peumomediastinum in the Newborn.
Dong Gwan Han
Department of Pediatrics, Yonsei University,College of Medicine,Seoul, Korea
新生兒 肺外空氣湯出(氣縱隔의 臨床的 考察)
韓東觀
延世醫大 小兒科學敎室
Abstract
A retrospective review was performed of 15 medical records to study the pneumomedia- stinum in the newborn during last 4 years from Jan. 1980 through Dec. 1983 at Severance Hospital of Yonsei University. Tne results were as follows: 1) The incidence was 0.14% (15 of 8,737 live-births) during the neonatal period. Of those cases spontaneous pneumomediastinum was 66.7%(10 cases) and secondary pneumomedia- stinum 33.3%(5 cases). Males were twice as frequent as females in ratio. 2) 73.3% had pneumomediastinum alone and 26.7% had an associated pneumomediastinum. Subcutaneous emphysema in the neck and chest wall found in 33.3%. 3) There were obstetric complications in 80.0%, severe neonatal asphyxia in 33.3%, premature and postmature in 26.7%, 80.0% of the pneumomediastinum occurred within:24 hours of life. 4) Symptoms and signs were cyanosis, tachypnea, chest retraction, expiratory grunting in order of frequency. 11 out of the 15 cases had underlying pulmonary diseases, such as meconium aspiration syndrome 46.7%, transient tachypnea of the newborn 13.3% andlhya- line membrane disease 13.3%. 5) 33.3% was treated conservatively with oxygen and 13.2% required needle aspiration. And the rest 53.3% was treated with IMV or IPPV due to underlying pulmonary disease. Among the 5 cases(33.3%) died during intensive care, 4 cases had underlying pulmonary- disease. Mortality was thought to be influenced by the underlying pulmonary diseases rather than the care.
Key Words: Pneumomediastinum, Pneumothorax and pulmonary interstitial emphysema jn the newborn, Subcutaneous emphysema, HMD, MAS, Mechanical ventilation


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