What is a pneumothorax?

Normally the air that we breathe goes down the trachea (windpipe) to a series of branches of the windpipe called bronchi. The air then goes to the air sacs where oxygen is delivered to the blood and carbon dioxide is released. If the air sacs become overfilled with air, the air can break out of air sacs and get into spaces where it should not be. In a pneumothorax the air becomes trapped between the chest wall and the lung causing the lung to collapse.

Which babies get air leaks?

Although a pneumothroax (air leak) can occur in any baby, it is more common if:

• The baby has underlying lung disease. The more severe the disease, the higher the risk for air leak
• The baby needs CPAP (continuous positive airway pressure)
• The baby needs mechanical ventilation (breathing machine or respirator)

Why do babies get an air leak?

• The lungs are not yet fully developed and the air sacs are more susceptible to rupture.
• If the baby has lung disease, some air sacs are open and others are closed. Like blowing up balloons, it is easier to put lots of air into an air sac that has been previously opened than it is to put a small amount of air into an air sac that has never been opened.

What can be done to treat a pneumothorax?

Some air leaks (pneumothoracies) are easier to treat than others. Approaches to treatment include:

• If the air leak (pneumothorax) is small, not increasing, and not causing significant problems, it may not need to be treated. The air gradually reabsorbs into the body.
• Occasionally, a pneumothorax can be treated by inserting a needle into the chest and sucking out the air with a syringe. Often, however, it will recollect.
• A tube, called a chest tube, can be placed between two ribs and into the chest cavity between the lung and the chest wall. The tube is placed in the area where the air is collecting and connected to continuous suction to remove the air until the leak seals over.

Is a pneumothorax serious?

Depending on the number of air leaks (pneumothoracies), the amount of air, and the space where it is located, the symptoms and seriousness of the pneumothorax may vary. A large pneumothorax usually causes sudden and rapid deterioration.

Will it get better?

As your baby's underlying lung disease improves, the air leak also improves. However, babies who have had a pneumothorax often improve more slowly than babies who have not. When the tube or tubes no longer drain air, they will be removed. Once the tubes are out and the baby is off the breathing machine or CPAP, pneumothorax usually does not recur.