Use of Fibrin Glue in the Treatment of Persistent Pneumothorax in Premature Infants at the Limit of Viability: Ethical Issues and Two and A Half Years Follow-Up.

Autor:	Rutkowska M; Department of Epidemiology and Biostatistics, Institute of Mother and Child, Warsaw, Poland., Woynarowska M; Neonatal Intensive Care Unit, Bielanski Hospital in Warsaw, Poland., Terczyńska I; Neonatal Outpatient Clinic, Institute of Mother and Child, Warsaw, Poland., Seroczyńska M; Neonatal Outpatient Clinic, Institute of Mother and Child, Warsaw, Poland., Mydlak D; Clinic of Surgery of Children and Adolescent, Institute of Mother and Child, Warsaw, Poland., Mądzik J; Department of Diagnostic Imaging, Institute of Mother and Child, Warsaw, Poland., Nowakowska E; Otolaryngology Clinic, Institute of Mother and Child, Warsaw, Poland., Niepokój K; Department of Medical Genetics, Institute of Mother and Child, Warsaw, Poland., Szczepaniak S; The Catholic Academy in Warsaw, Collegium Joanneum, Warsaw, Poland., Polak K; Neonatal Outpatient Clinic, Institute of Mother and Child, Warsaw, Poland.
Jazyk:	angličtina
Zdroj:	Journal of mother and child [J Mother Child] 2023 Nov 22; Vol. 27 (1), pp. 190-197. Date of Electronic Publication: 2023 Nov 22 (Print Publication: 2023).
DOI:	10.34763/jmotherandchild.20232701.d-23-00061
Abstrakt:	Introduction: Due to the extreme immaturity of many internal organs, including lungs, infants at the limit of viability are more predisposed to a pneumothorax (PTX). In some cases, PTX becomes persistent. Previously, only a few attempts of PTX treatment with fibrin glue were reported. However, its impact on further lung development is unknown. Case Report: We present a case of an extremely preterm infant with persistent PTX who was successfully treated with fibrin glue. In addition, we present a two-and-a-half-year corrected age follow-up focusing on respiratory problems, motor development and sensory organs. Furthermore, we touch upon the related ethical issues. Conclusions: Fibrin glue should be used to treat persistent PTX even in an extremely preterm infant. No adverse effects were observed. At the two-and-a-half-year corrected age follow-up, despite severe bronchopulmonary dysplasia development, no serious pulmonary problems were observed. However, the child's development is uncertain. This situation raises important ethical issues concerning saving the lives of infants at the limit of viability. (© 2023 Magdalena Rutkowska et al., published by Sciendo.)
Databáze:	MEDLINE
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