{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:53:18Z","timestamp":1777891998829,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T00:00:00Z","timestamp":1454284800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2016,2]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Causing pneumothorax is one of the main concerns of lung recruitment maneuvers in pediatric patients, especially newborns. Therefore, these maneuvers are not performed routinely during anesthesia. Our objective was to determine the pressures that cause pneumothorax in healthy newborns by a prospective experimental study of 10 newborn piglets (<48 h old) with healthy lungs under general anesthesia.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n \n The primary outcome was peak inspiratory pressure (PIP) causing pneumothorax. Animals under anesthesia and bilateral chest tube catheterization were randomly allocated to 2 groups: one with PEEP and fixed inspiratory driving pressure of 15 cm H\n 2<\/jats:sub>\n O (PEEP group) and the second one with PEEP = 0 cm H\n 2<\/jats:sub>\n O and non-fixed inspiratory driving pressure (zero PEEP group). In both groups, the ventilation mode was pressure-controlled, and PIP was raised at 2-min intervals, with steps of 5 cm H\n 2<\/jats:sub>\n O until air leak was observed through the chest tubes. The PEEP group raised PIP through 5-cm H\n 2<\/jats:sub>\n O PEEP increments, and the zero PEEP group raised PIP through 5-cm H\n 2<\/jats:sub>\n O inspiratory driving pressure increments.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Pneumothorax was observed with a PIP of 90.5 \u00b1 15.7 cm H\n 2<\/jats:sub>\n O with no statistically significant differences between the PEEP group (92 \u00b1 14.8 cm H\n 2<\/jats:sub>\n O) and the zero PEEP group (89 \u00b1 18.2 cm H\n 2<\/jats:sub>\n O). The zero PEEP group had hypotension, with a PIP of 35 cm H\n 2<\/jats:sub>\n O; the PEEP group had hypotension, with a PIP of 60 cm H\n 2<\/jats:sub>\n O (\n P<\/jats:italic>\n = .01). The zero PEEP group presented bradycardia, with PIP of 40 cm H\n 2<\/jats:sub>\n O; the PEEP group presented bradycardia, with PIP of 70 cm H\n 2<\/jats:sub>\n O (\n P<\/jats:italic>\n = .002).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n \n Performing recruitment maneuvers in newborns without lung disease is a safe procedure in terms of pneumothorax. Pneumothorax does not seem to occur in the clinically relevant PIPs of <50 cm H\n 2<\/jats:sub>\n O. Hemodynamic impairment may occur with high driving pressures. More studies are needed to determine the exact hemodynamic impact of these procedures and pneumothorax PIP in poorly compliant lungs.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4187\/respcare.04250","type":"journal-article","created":{"date-parts":[[2015,11,10]],"date-time":"2015-11-10T20:48:30Z","timestamp":1447188510000},"page":"142-148","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Neonatal Pneumothorax Pressures Surpass Higher Threshold in Lung Recruitment Maneuvers: An In Vivo Interventional Study"],"prefix":"10.1177","volume":"61","author":[{"given":"Patricio","family":"Gonz\u00e1lez-Pizarro","sequence":"first","affiliation":[{"name":"Anaesthesia and Intensive Care Department, Akademiska Sjukhuset, Uppsala, Sweden."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Garc\u00eda-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Anaesthesiology and Critical Care Department, Puerta de Hierro University Hospital, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Canfr\u00e1n","sequence":"additional","affiliation":[{"name":"Veterinary Clinical Hospital, Complutense University, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Gilsanz","sequence":"additional","affiliation":[{"name":"Anaesthesiology Department, La Paz University Hospital, Madrid, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,2,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196311072691901"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2009.12.002"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/82.4.551"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2010.02.006"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200301000-00006"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31829102de"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000068484.67655.1A"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5337(03)00032-7"},{"issue":"1","key":"e_1_3_3_10_2","first-page":"18","article-title":"Mechanical ventilation in acute respiratory failure: recruitment and high positive end-expiratory pressure are necessary","volume":"11","author":"Barbas CS","year":"2005","unstructured":"Barbas CS, , de Matos GF, , Pincelli MP, , da Rosa Borges E, , Antunes T, , de Barros JM, et al. Mechanical ventilation in acute respiratory failure: recruitment and high positive end-expiratory pressure are necessary. Curr Opin Crit Care, 2005; 11(1):18\u201328.","journal-title":"Curr Opin Crit Care"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00118.2004"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2009.02.008"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-005-2799-6"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000278087.18459.a5"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-001-1178-1"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.08531441"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2009.10.002"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1439-y"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2005.04187.x"},{"issue":"1","key":"e_1_3_3_20_2","first-page":"7","article-title":"Mechanical ventilation in children with acute respiratory failure","volume":"10","author":"Mehta NM","year":"2004","unstructured":"Mehta NM, , Arnold JH. Mechanical ventilation in children with acute respiratory failure. Curr Opin Crit Care, 2004; 10(1):7\u201312.","journal-title":"Curr Opin Crit Care"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc5940"},{"key":"e_1_3_3_22_2","first-page":"P22","volume-title":"Assisted ventilation of the neonate","author":"Harris T","year":"1988","unstructured":"Harris T. Physiological principles. In: Goldsmith JP, , Karotkined EH, editors. Assisted ventilation of the neonate. 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