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Is high-concentration oxygen therapy more effective than targeted oxygen therapy in neonatal non-tension pneumothorax?
  1. Anna Gregory1,
  2. Andrew K Ewer1,2,
  3. Anju Singh1
  1. 1 Neonatal Unit, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
  2. 2 Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Anju Singh, Neonatal Unit, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham B15 2TG, UK; anjusingh{at}nhs.net

https://doi.org/10.1136/archdischild-2018-315659

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    Clinical scenario

    A term newborn is admitted to the neonatal unit with positive pulse oximetry screen1 and tachypnoea. The respiratory rate is 70 breaths/min but there are no other signs of respiratory distress. The preductal pulse oximeter oxygen saturations (SpO2) are 91% and postductal SpO2 are 90% in room air. The baby is commenced on low-flow oxygen at 0.05 L/min, which improves both preductal and postductal SpO2 to 95%. Following this, the baby undergoes a chest radiograph which reveals a left-sided pneumothorax with no significant lung collapse or mediastinal shift. As this is an incidental finding and the baby shows no clinical or radiological signs of tension pneumothorax, you question the need to treat with higher concentration oxygen therapy as has previously been routine practice.

    Structured clinical question

    In term and late preterm neonates (≥34 weeks) with spontaneous pneumothorax (SP) without clinical or radiological signs of tension (patient), is high-concentration oxygen therapy (intervention) more effective than …

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    Footnotes

    • Contributors AG and AS contributed to the literature search and manuscript. AKE helped with the revision of the manuscript.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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