{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:44:42Z","timestamp":1757616282929,"version":"3.44.0"},"reference-count":15,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2001,7,6]]},"published-print":{"date-parts":[[2001,11,1]]},"abstract":"\n AIM<\/jats:title>\n To examine the relation of overventilation and other clinical events to the development of pneumothoraces in ventilated neonates.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A case-control study.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Fifty three (8.7%) of 606 ventilated neonates developed a pneumothorax. Eighteen (34%) cases and 23 (43%) controls were unintentionally overventilated (Paco<\/jats:sc>\n 2<\/jats:sub>\u2009<\u20094 kPa) at some time before the pneumothorax developed in the cases (odds ratio (OR)\u2009=\u20090.78, 95% confidence interval (CI) 0.48 to 1.27). In the three hours before the diagnosis of pneumothorax, more cases than controls were reintubated (21\/53 v<\/jats:italic> 4\/53; OR\u2009=\u20095.25, 95% CI 1.9 to 14.3), and also in seven cases (one control) the mean airway pressure was increased, whereas in nine controls (no cases) it was reduced (\u03c72<\/jats:sup> \u2009=\u200912.0, df\u2009=\u20092, p\u2009=\u20090.001). Seven of 18 neonates diagnosed by transillumination had undergone no clinical procedures before diagnosis compared with five of 35 diagnosed radiologically (OR\u2009=\u20092.7, 95% CI 1.0 to 7.4).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Unintentional overventilation was not associated with pneumothoraces. In the hours before diagnosis, there was increased clinical intervention, including reintubation; this was less so in those diagnosed by transillumination. The study did not elucidate whether such interventions caused the pneumothorax or were secondary to a failure to diagnose it.<\/jats:p>\n \n \n \n Key messages<\/jats:title>\n \n \n Brief inadvertent overventilation was not associated with pneumothoraces<\/jats:p>\n <\/jats:list-item>\n \n There was a cluster of clinical procedures before the diagnosis of a pneumothorax. This included reintubation and increases in airway pressure. This study did not establish whether these procedures caused pneumothoraces or were undertaken because an undiagnosed pneumothorax was already causing clinical deterioration.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/fn.85.3.f201","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T06:32:19Z","timestamp":1027751539000},"page":"F201-F203","source":"Crossref","is-referenced-by-count":25,"title":["Events before the diagnosis of a pneumothorax in ventilated neonates"],"prefix":"10.1136","volume":"85","author":[{"given":"M","family":"Watkinson","sequence":"first","affiliation":[{"name":"Neonatal Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I","family":"Tiron","sequence":"additional","affiliation":[{"name":"Neonatal Unit, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2001,11,1]]},"reference":[{"key":"2025090510594116000_85.3.F201.1","unstructured":"Crowley P (2000) Prophylactic corticosteroids for preterm birth. Cochrane Database of Systematic Reviews, p 1."},{"key":"2025090510594116000_85.3.F201.2","doi-asserted-by":"crossref","first-page":"F70","DOI":"10.1136\/fn.77.1.F70","article-title":"Systematic review of prophylactic v rescue surfactant.","volume":"77","author":"Morley","year":"1997","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"2025090510594116000_85.3.F201.3","doi-asserted-by":"crossref","first-page":"226","DOI":"10.2165\/00003495-199651020-00004","article-title":"Natural vs. Synthetic surfactants in neonatal respiratory distress syndrome.","volume":"51","author":"Halliday","year":"1996","journal-title":"Drugs"},{"key":"2025090510594116000_85.3.F201.4","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1542\/peds.76.4.488","article-title":"Management of infants with severe respiratory failure and persistence of fetal circulation without hyperventilation.","volume":"76","author":"Wung","year":"1985","journal-title":"Pediatrics"},{"key":"2025090510594116000_85.3.F201.5","doi-asserted-by":"publisher","DOI":"10.1136\/fn.82.1.F5"},{"key":"2025090510594116000_85.3.F201.6","unstructured":"Henderson-Smart DJ Bhuta T Cools F (2000) Effective high frequency oscillation ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants. Cochrane Database of Systematic Reviews, p 1."},{"key":"2025090510594116000_85.3.F201.7","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1542\/peds.69.2.144","article-title":"Relationship of pneumothorax to the occurrence of intraventricular haemorrhage in preterm newborns.","volume":"69","author":"Hill","year":"1982","journal-title":"Pediatrics"},{"key":"2025090510594116000_85.3.F201.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(05)80964-3"},{"key":"2025090510594116000_85.3.F201.9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1542\/peds.79.1.26","article-title":"Is chronic lung disease in low birth infants preventable? A survey of eight centers.","volume":"79","author":"Avery","year":"1987","journal-title":"Pediatrics"},{"key":"2025090510594116000_85.3.F201.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1993.tb12637.x"},{"key":"2025090510594116000_85.3.F201.11","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-200009000-00025"},{"key":"2025090510594116000_85.3.F201.12","doi-asserted-by":"publisher","DOI":"10.1136\/adc.69.5_Spec_No.479"},{"key":"2025090510594116000_85.3.F201.13","doi-asserted-by":"crossref","first-page":"F14","DOI":"10.1136\/fn.84.1.F14","article-title":"Randomised study comparing extent of hypocarbia in preterm infants during conventional and trigger ventilation.","volume":"84","author":"Luyt","year":"2000","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"key":"2025090510594116000_85.3.F201.14","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1542\/peds.56.3.355","article-title":"Diagnosis of pneumothorax or pneumomediastinum in the neonate by transillumination.","volume":"56","author":"Kuhns","year":"1975","journal-title":"Pediatrics"},{"key":"2025090510594116000_85.3.F201.15","doi-asserted-by":"publisher","DOI":"10.1136\/fn.72.2.F123"}],"container-title":["Archives of Disease in Childhood - Fetal and Neonatal Edition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/fn.85.3.F201","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T18:24:36Z","timestamp":1757096676000},"score":1,"resource":{"primary":{"URL":"https:\/\/fn.bmj.com\/lookup\/doi\/10.1136\/fn.85.3.F201"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,11,1]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2001,11,1]]},"published-print":{"date-parts":[[2001,11,1]]}},"alternative-id":["10.1136\/fn.85.3.F201"],"URL":"https:\/\/doi.org\/10.1136\/fn.85.3.f201","relation":{},"ISSN":["1359-2998","1468-2052"],"issn-type":[{"type":"print","value":"1359-2998"},{"type":"electronic","value":"1468-2052"}],"subject":[],"published":{"date-parts":[[2001,11,1]]}}}