Persistent pulmonary air leak in the pediatric intensive care unit: Characteristics and outcomes

• Published in: Pediatric pulmonology 2021-08, Vol.56 (8), p.2729-2735
• Main Authors: Kagan, Shelly, Nahum, Elhanan, Kaplan, Eytan, Kadmon, Gili, Gendler, Yulia, Weissbach, Avichai
• Format: Article
• Language: English
• Subjects: alveolopleural fistula; Broncho pleural fistula; Hospitalization; Intensive care; pediatric intensive care unit; Pediatrics; persistent air leak; Pneumonia; Pneumothorax
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.25509

Background Persistent air leak (PAL) complicates various lung pathologies in children. The clinical characteristics and outcomes of children hospitalized in the pediatric intensive care unit (PICU) with PAL are not well described. We aimed to elucidate the course of disease among PICU hospitalized children with PAL. Methods A retrospective cohort study of all PICU‐admitted children aged 0–18 years diagnosed with pneumothorax complicated by PAL, between January 2005 and February 2020 was conducted at a tertiary center. PAL was defined as a continuous air leak of more than 48 h. Results PAL complicated the course of 4.8% (38/788) of children hospitalized in the PICU with pneumothorax. Two were excluded due to missing data. Of 36 children included, PAL was secondary to bacterial pneumonia in 56%, acute respiratory distress syndrome (ARDS) in 31%, lung surgery in 11%, and spontaneous pneumothorax in 3%. Compared to non‐ARDS causes, children with ARDS required more drains (median, range: 4, 3–11 vs. 2, 1–7; p