Jornal de Pediatria
Print version ISSN 0021-7557
On-line version ISSN 1678-4782
BRUNHEROTTI, Marisa A.A.; VIANNA, Jacqueline R. Freitas and SILVEIRA, Carmem S.T.. Decrease of the occurrence of pneumothorax in newborns with respiratory distress syndrome through reduction of ventilatory parameters. J. Pediatr. (Rio J.) [online]. 2003, vol.79, n.1, pp.75-80. ISSN 0021-7557. http://dx.doi.org/10.1590/S0021-75572003000100013.
Objective: to verify if the strategy of reduction of the ventilatory parameters decreases the occurrence of pneumothorax in preterm newborns with respiratory distress syndrome. Methods: a longitudinal prospective study of preterm newborns with respiratory distress syndrome was carried out at the Pediatric Intensive Care Center of Hospital Santa Casa de Misericórdia of Franca, from July 1999 to June 2000. One hundred and twenty-seven female and male newborns between the 25th and the 37th week of gestation, with birthweight varying from 625 g to 2500 g were studied. The ventilatory parameters were analyzed during the assisted mechanical ventilation in two groups of patients: the controlled group and the other group, in which the parameters were reduced, by investigating and comparing the occurrence of pneumothorax. The association of data was verified through chi-square test; level of significance a = 0.05 and 0.01, and the difference among the studied parameters was obtained through the Students t test. Results: the results show lower parameters of inhalation flow and shorter period of inhalation, generating minor tidal volume, decrease of the occurrence of pneumothorax (8.1% compared to 24.5% of the controlled group), with statistical significance (c2 = 6.545; p < 0.05), and without significance related to mortality and hospital discharge (c2 = 0.736; p = 0.391). Conclusions: this study verified that lower inhalation flow and shorter period of inhalation in preterm newborns with respiratory distress syndrome were associated with the decrease of the occurrence of pneumothorax.
Keywords : pneumothorax; preterm newborn; respiratory distress syndrome; protective ventilation strategy.