eumothoraces on admission chest radiographs in late preterm/term neonates
Journal Title: Journal of Radiology and Imaging - Year 2018, Vol 3, Issue 2
Abstract
Purpose: To determine whether subtle anteromedial or subpulmonic pneumothorax (PTX) on neonatal admission chest radiograph is associated with depressed Apgar scores and significant resuscitation. Methods: Retrospective review of 375 neonates admitted to the Neonatal Intensive Care Unit from 2010-2014 with respiratory distress born at 34 - 42 weeks gestation. All patients received anterior-posterior supine chest radiographs within 48 hours of birth. Records were reviewed for details on patient demographics, route of delivery, and Apgar scores at 1 and 5 min. Image interpretations were performed by radiologists and neonatologists blinded to patient clinical details and radiology reports. Significant resuscitative patterns were coded as early or late. Fisher’s exact test and odds ratios were used to determine the significance. Results: 14/375 (4%) were reported positive for PTX by both radiologist and neonatologist groups. Among these 14, 11 (79%) had early resuscitation with positive pressure ventilation and/or continuous positive airway pressure within 5 min of birth, which was significant compared to the neonates without PTX (p = 0.026). The median one minute Apgar for neonates with PTX was lower (5.0) than those without PTX (8.0). No neonate with these chest radiograph findings developed a tension PTX. Conclusion: The presence of small anteromedial or subpulmonic PTX is associated with a difficult transition to extra-uterine life which is correlated with low Apgar scores at one minute. Reporting these PTX is important due to its relation to early resuscitation. These radiograph findings may warrant closer monitoring and a higher intensity of care.
Authors and Affiliations
Grace Chan, April Jones, Anugayathri Jawahar, Jennifer Lim-Dunham, Sachin Amin, Jonathan Muraskas
Keywords
Related Articles
- EP ID EP532939
- DOI 10.14312/2399-8172.2018-2
- Views 53
- Downloads 0
Penetrating aortic ulcer manifesting as atypical chest pain
This is a case report of a penetrating aortic ulcer that presented as atypical chest pain. Imaging modalities for the diagnosis of aortic ulcers include computed tomography angiography, magnetic resonance angiography, an...
Third degree skin burns caused by a MRI conditional electrocardiographic monitoring system
Two unusual cases of third degree skin burns are reported using MRI approved electrocardiographic leads. This is very uncommon as it is most often the electrodes which are the source of heat related issues. Both patients...
MRI system scoring for differentiation of malignant versus benign stricture of the common bile duct
The purpose of this study was to evaluate the ability of magnetic resonance imaging (MRI) to differentiate between malignant and benign strictures of the common bile duct by using a scoring system. MRI scans of 34 patien...
10-MV X-ray dose calculation in water for MLC and wedge fields using a convolution method with X-ray spectra reconstructed as a function of off-axis distance
Purposes: This paper highlights a 10-MV X-ray convolution dose calculation method in water using primary and scatter dose kernels formed for energy bins of X-ray spectra reconstructed as a function of the off-axis distan...
Computed tomography of congenital heart disease in patients with heterotaxy syndrome
Background: Heterotaxy syndrome (HS) or situs ambiguous, is determined as a type of congenital disorders which is caused by failure to establish normal left–right (L–R) asymmetry during embryonic development. One of the...