Severe neonatal air leak syndrome – Question

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

Keywords

• air leak
• pneumopericardium
• pneumothorax
• respiratory distress
• prematurity