Yenidoğan pnömotorakslı hastalarda anjiyocat ile sualtı drenajının toraks tüpüne göre değerlendirilmesi
Loading...
Date
2019
Authors
Katar, Selahattin
Taşkesen, Mustafa
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
GİRİŞ ve AMAÇ: Pnömotoraks yenidoğan hastalarda morbidite ve mortalitesi yüksek olan önemli bir solunum sıkıntısı nedenidir. Semptomatik pnömotorakslı hastalarda acil olarak plevral boşluktaki serbest hava boşaltılmazsa ölümle sonuçlanabilir. Bu yazıda amaç pnömotoraks tanısıyla takip edilen hastaların, daha az agresif ve kolay bir yöntem olan branül ile kapalı su altı drenajı ile plevral boşluktaki serbest hava drenajının sağlanabildiğini işaret etmektir. YÖNTEM ve GEREÇLER: Ağustos 2010 - Kasım 2015 tarihleri arasında yenidoğan yoğun bakım ünitesinde pnömotoraks tanısı ile yatırılan hastaların dosyaları retrospektif olarak incelendi. BULGULAR: 2010 Ağustos -2015 Kasım tarihleri arasında yenidoğan yoğun bakım ünitemize toplam 1017 hasta yatırıldı. Bunların %1.6’sı (n: 17) pnömotoraks tanısı aldı. Ortalama vücut ağırlığı: 2314.7±1023.4 gram (730-3600gram), gestasyonel yaş ortalaması: 34.0±5.4 hafta (24-40 hafta) idi. İki hastada bilateral, bir hastada solda, 13 hastada is sağda pnömotoraks görüldü. Üç hasta herhangi bir girişim olmadan spontan düzelirken, dört hastada tüp torakostomi, 10 hastada ise branül ile kapalı su altı drenajı sağlandı. Tüp torakostomi uygulanan hastalardan birinde tüp yerinden çıktığı için yeniden girişim uygulandı. Branül ile drenaj sağlanan hastalarda herhangi bir komplikasyon görülmedi. Primer tanı dokuz hastada respiratuar distres sendromu, beş hastada asfiksi-mekonyum aspirasyonu, üç hastada yenidoğanın geçici takipnesi idi. İki hasta kaybedildi. TARTIŞMA ve SONUÇ: Pnömotoraksta zaman kaybı olmadan ve agresif cerrahi bir işleme maruz kalmadan yenidoğan pnömotorakslı hastalarda branül ile kapalı su altı drenajının, çocuk cerrahisi uzmanına ulaşılamadığında, yenidoğan konusunda belli tecrübesi olan hekimler tarafından kolay uygulanabileceğini düşünmekteyiz.
INTRODUCTION: Pneumothorax is a major cause of respiratory distress and associated with increased mortality and morbidity in newborn patients. The aim of this article was to emphasize the usability of underwater seal drainage with branule, which is a simple and non-aggressive method, in the treatment of newborn patients with pneumothorax. METHODS: The medical records of patients who were hospitalized in the neonatal intensive care unit with a diagnosis of pneumothorax between August 2010 and November 2015 were investigated retrospectively. RESULTS: A total of 1017 patients were hospitalized in our neonatal intensive care unit between August 2010 and November 2015. Of them, 1.6% (n: 17) had pneumothorax. The mean body weight was 2314.7±1023.4 g (730-3600 g) and gestational age was 34.0±5.4 weeks (24-40 weeks). Two patients had bilateral pneumothorax, one patient had left-sided pneumothorax, and 14 patients had right-sided pneumothorax. In three patients, pneumothorax spontaneously resolved without any procedure.Four patients underwent tube thoracostomy, and 10 patients were treated by underwater seal drainage with branule. In one of the patients who underwent tube thoracostomy, reintervention was performed because of the tube dislocation. The primary disease which caused pneumotorax was diagnosed as respiratory distress syndrome in nine patients, asphyxia-meconium aspiration in five patients, and transient tachypnea of the newborn in three patients. Two patients died. DISCUSSION and CONCLUSION: In newborn patients with pneumothorax, underwater drainage with branule may be used by physicians experienced in neonatal care as a quick and easy procedure when a pediatric surgeon is not available to perform the relatively more difficult and agressive option of thorax tube insertion.
INTRODUCTION: Pneumothorax is a major cause of respiratory distress and associated with increased mortality and morbidity in newborn patients. The aim of this article was to emphasize the usability of underwater seal drainage with branule, which is a simple and non-aggressive method, in the treatment of newborn patients with pneumothorax. METHODS: The medical records of patients who were hospitalized in the neonatal intensive care unit with a diagnosis of pneumothorax between August 2010 and November 2015 were investigated retrospectively. RESULTS: A total of 1017 patients were hospitalized in our neonatal intensive care unit between August 2010 and November 2015. Of them, 1.6% (n: 17) had pneumothorax. The mean body weight was 2314.7±1023.4 g (730-3600 g) and gestational age was 34.0±5.4 weeks (24-40 weeks). Two patients had bilateral pneumothorax, one patient had left-sided pneumothorax, and 14 patients had right-sided pneumothorax. In three patients, pneumothorax spontaneously resolved without any procedure.Four patients underwent tube thoracostomy, and 10 patients were treated by underwater seal drainage with branule. In one of the patients who underwent tube thoracostomy, reintervention was performed because of the tube dislocation. The primary disease which caused pneumotorax was diagnosed as respiratory distress syndrome in nine patients, asphyxia-meconium aspiration in five patients, and transient tachypnea of the newborn in three patients. Two patients died. DISCUSSION and CONCLUSION: In newborn patients with pneumothorax, underwater drainage with branule may be used by physicians experienced in neonatal care as a quick and easy procedure when a pediatric surgeon is not available to perform the relatively more difficult and agressive option of thorax tube insertion.
Description
Keywords
Pnömotoraks, Tedavi, Yenidoğan, Newborn, Pneumothorax, Treatment
Citation
Katar, S. ve Taşkesen, M. (2019). "Yenidoğan pnömotorakslı hastalarda anjiyocat ile sualtı drenajının toraks tüpüne göre değerlendirilmesi". Güncel Pediatri, 17(1), 151-156.