Pulmonary atelectasis in newborns with clinically treatable diseases who are on mechanical ventilation: clinical and radiological aspects

Abstract Objective: To analyze the radiological aspects of pulmonary atelectasis in newborns on mechanical ventilation and treated in an intensive care unit, associating the characteristics of atelectasis with the positioning of the head and endotracheal tube seen on the chest X-ray, as well as with the clinical variables. Materials and Methods: This was a retrospective cross-sectional study of 60 newborns treated between 1985 and 2015. Data were collected from medical records and radiology reports. To identify associations between variables, we used Fisher's exact test. The level of significance was set at p < 0.05. Results: The clinical characteristics associated with improper positioning of the endotracheal tube were prematurity and a birth weight of less than 1000 g. Among the newborns evaluated, the most common comorbidity was hyaline membrane disease. Atelectasis was seen most frequently in the right upper lobe, although cases of total atelectasis were more common in the left lung. Malpositioning of the head showed a trend toward an association with atelectasis in the left upper lobe. Conclusion: Pulmonary atelectasis is a common complication in newborns on mechanical ventilation. Radiological evaluation of the endotracheal tube placement provides relevant information for the early correction of this condition.

摘要：
研究目的：分析收治于重症监护病房（intensive care unit, ICU）并接受机械通气（mechanical ventilation）治疗的新生儿肺不张（pulmonary atelectasis）的影像学特征，将肺不张的相关特征与胸部X线片（chest X-ray）中显示的头部位置、气管导管（endotracheal tube）位置及临床变量进行关联分析。
材料与方法：本研究为回顾性横断面研究，纳入1985年至2015年间收治的60名新生儿。研究数据取自病历与放射学报告。为分析变量间的关联，我们采用费希尔精确检验（Fisher's exact test），设定显著性水平为p<0.05。
结果：与气管导管位置不当相关的临床特征为早产及出生体重低于1000g。纳入本次研究的新生儿中，最常见的合并症为透明膜病（hyaline membrane disease）。肺不张最常累及右肺上叶，尽管全肺不张病例在左肺更为多见。头部位置异常与左肺上叶肺不张存在关联趋势。
结论：肺不张是接受机械通气的新生儿常见并发症。通过影像学评估气管导管位置，可为该病症的早期矫正提供具有参考价值的临床信息。