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The following is a summary of “An Improvement Project to Lower Pneumothorax Rates in Neonates Born at 36 Weeks’ Gestational Age or Beyond,” published in the December 2024 issue of Pediatrics by Sandall et al.
High pneumothorax rates have been reported in term neonates receiving continuous positive airway pressure (CPAP) in the delivery room.
Researchers conducted a retrospective study to evaluate if reducing the use of CPAP in the delivery room decreases pneumothorax rates in neonates born at 36 weeks of gestation or beyond.
They implemented revisions to the delivery room respiratory care algorithm, focusing on reducing CPAP use. Data on CPAP use and pneumothorax events were collected for neonates born at 36 weeks of gestation or more, and statistical process control charts were used to evaluate changes.
The results showed that CPAP use in the delivery room decreased from 3.4% to 1.0%, with the frequency of pneumothorax also declining, increasing the number of births between pneumothorax events from 293 to 530. No increase in the number of neonates requiring higher-level respiratory care was observed (P-value not specified).
They concluded that reducing the use of CPAP in the delivery room was associated with fewer pneumothorax cases without an increase in the need for higher-level respiratory care.
