Abstract 80

Background: PTX in the newborn has significant and morbidity. Early diagnosis might improve the outlook.

Subjects: A retrospective cohort of 42 cases of PTX from 1993-1996. Measures: Computerised trend of transcutaneous carbon dioxide (CO2) and oxygen (O2), notes and x-rays of 42 cases of PTX were reviewed. The time of onset could be identified from the trend levels and the time of clinical diagnosis from the timed x-rays. The difference was the time the condition was undiagnosed. The interventions that the babies received during this time were noted.

Results: Mortality before discharge was 45% (19cases), 4 died within 2 hours. The median time (range) between onset of PTX and clinical diagnosis was 127 (45-660) minutes. In most the endotracheal tube was aspirated, in 76% the monitor was re-sited, and in 40% the baby was re-intubated before diagnosis was made.

Conclusions: The clinical diagnosis of PTX is late. Trend monitoring of CO2 could allow earlier diagnosis.