Pneumothorax is a lung disease characterized by accumulation of air in the pleural space. It is the space between lung and the wall of chest. Presence of air in pleural cavity compresses the lung tissue and compromises lung elasticity leading to collapse of the lung. Pneumothorax can occur in anyone from infants to adults.
The primary reason for pneumothorax in infants is bursting of over-inflated alveoli, the tiny air sacs present in lung. When the alveoli burst the air leaks from the lungs into the space between the lungs and chest wall called pleural space.Infants who are born prematurely are more vulnerable to develop this condition. New born who aspirate meconium during birth or infants who are on ventilators are also at risk of developing pneumothorax.
The child with this lung condition suffers from breathing difficulty and cyanosis. Pneumothorax in infants and children can be life threatening if immediate treatment measures are not taken.
What Causes Pneumothorax In Infants?
Pneumothorax in infants is normally seen in babies who are born prematurely. It is because in preterm babies, there is lack of slippery substance which keeps the alveoli of lung inflated.This substance is called surfactant. If the baby is put on ventilator due to breathing problem, it may generate extra pressure on the lungs. Sometimes the alveoli may burst due to the pressure. The air from alveoli will leak into the space between the chest wall and the lungs.
Aspiration of meconium during birth can also lead to pneumothorax. Meconium is the first bowel movement. This may lead to breathing difficulty and the newborn baby may require mechanical aid for respiration. Infection of the lungs such as pneumonia can also cause pneumothorax. New born babies with congenital malformation of lungs may also suffer from pneumothorax as one of the complications.
Symptoms Of Pneumothorax In Infants
Following are the signs and symptoms that most babies experience when they suffer from pneumothorax:
- Moderate to severe distress while breathing.
- Increase in rate of respiration.
- Grunting noise while breathing.
- Flaring of nostril.
- Bluish discoloration of nails, tongue, and skin. It occurs due to reduced amount of oxygen saturation in the blood and tissues.
- Increased restlessness and irritability.
- Retraction of chest.
- Rapid pulse and heart rate.
- Due to breathing difficulty, the infant becomes weak gets tired easily.
Diagnosis And Management Of Pneumothorax
Pneumothorax in infants is diagnosed by the doctor. Following steps will help to diagnose the condition:
- The baby is quiet distressful while breathing. From the appearance as well as examining the baby the doctor is able to diagnose the condition. There is rapid breathing along with abnormal sounds while examining the chest with stethoscope.
- Laboratory arterial blood gas test will show abnormal results.
- X-ray of chest is abnormal. It helps to confirm the diagnosis form other lung problems.
Pneumothorax in infants can be life threatening, thus all patients are carefully observed and treated. Often the symptoms are absent or the child is less distressful. In such situation, doctors may only observe and monitor the child for few days.
But in majority of cases the child may need supplemental oxygen and thoracotomy, a procedure in which a fine needle is inserted into the pleural space to remove the accumulated air.
The prognosis of pneumothorax in infants is promising if the air is removed with the needle as early after detection of the disease.