Clinical Analysis Of 43 Cases With Atelectasis In The Newborn

Objective: To investigate the clinical characteristics of neonatal atelectasis, and to provide basis for the diagnosis as well as treatment of atelectasis in the newborn.Methods: We reviewed the charts of 43 newborns with atelectasis, who were hospitaled in Children's Hospital of Chongqing Medical University from December 1999 to January 2010. Clinical data were collected and analyzed retrospectively. All statistical analyses were performed using SPSS 17.0 software.Results:1. Demographic characteristics: The minimum gestational age was 25 weeks While the maximum gestational age was 41 weeks. The mean gestational age was 37.68±3.43 weeks and 25.6% were preterm. The average age of onset was 9.53±9.58 days after birth. 62.8% patients were within the first 7 days. 38.2% patients were beyongd 7 days.2. Clinical manifestation: The manifestations and signs were atypical, similar with those of pneumonia. There were tachypnea (74.4%), cyanosis (58.1%), cough (55.8%), hoarse voice (27.9%), bucking (34.9%), foaming at the mouth (25.6%), fever (27.1%), rales (53.5%), 3 cases had percussion dullness (7.0%) and 9 cases (20.9%) had decreased breath sounds.3. Primary disease: the leading disease caused atelectasis in the newborn were pneumonia 33 cases (76.7%), followed by hyaline membrane disease (HMD, 32.8%), asphyxia 13.4%, meconium aspiration syndrome 7.5%, pneumonia combined with pulmonary hemorrhage 7.5%.4. Distribution of atelectasis: 26 atelectasis cases were in the right lung. Most of them were segmental atelectasis, just in the right upper lobe. Only 1 case was in the right middle lobe.5. Clinical management and prognosis:The main treatment measures include effective antibiotic therapy and respiratory management such as atomization, suction, back shotting as well as body position. 14 cases received bronchial lavage 1 or 2 times during the course of disease. After being treated for three days, the repeated plain chest radiographs of 67.4% neonate with atelectasis showed the features of re-expansion. Bronchial lavage group had 13 cases re-expansion, except 1 case. Without bronchial lavage group had 16 cases re-expansion, and 13 cases failed. Bronchial lavage group had significantly higher re-expansion rate than that of control group. There was a significantly difference (92.9% vs 65.2%, p <0.05). Conclusion: The atelectasis in newborn have atypical clinical charateristics. The most common etiology was inflammation which mainly caused by pneumonia. Most of atelectasis were segmental atelectasis in the right lung especially the upper lobe. Effective antibiotic therapy and positive management of airway were the key points for the re-expansion of atelectasis.