RESUMEN
Objectives: The aim of this work is to estimate the incidence of pneumothorax among Pediatric Intensive Care Unit admissions in five years period 1[st] of January 2008-31[st] December 2012] and to study the risk factors that may affect the development of pneumothorax in these cases
Study design: The medical records of all children admitted to Alexandria University Pediatric Intensive Care unit from 1[st] of January 2008 to 31[st] of December 2012 were reviewed retrospectively
Results: In this study, of 1298 admitted cases, 135 [10.4%] developed 151 episodes of pneumothorax. The most common cause for pneumothorax was found to be barotraurna related to mechanical ventilation [about 70% of cases of pneumothorax and central venous catheterization coming next [13.2% of cases of pneumothorax]. Mechanical ventilation was needed in 92.5% of cases of pneumothorax compared to 52.7% of cases without pneumothorax .We found significant statistical difference between cases with and without pneumothorax as regards age, weight, PIM2 score, PELOD score, Length of stay, mortality rate, diagnostic category[p<0.001], need for mechanical ventilation, duration of mechani ventilation, ventilator settings [PEEP,PIP ,Fio[2][P<0.001]. There was no significant statistical difference among cases with and without pneumothorax as regards sex and referral site
Conclusion: Iatrogenic pneumothorax is the most common cause of pneumothorax. Need for mechanical ventilation, high ventilator settings and longer duration of ventilation are considered as risk factors in addition to underlying illness, so it is very important to strictly apply protective lung strategies to minimize risk of pneumothorax in ventilated cases