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
, , , , , , , , e | 22 nov 2023
Article Category: Original paper
Pubblicato online: 22 nov 2023
Pagine: 190 - 197
Ricevuto: 05 lug 2023
Accettato: 15 set 2023
DOI: https://doi.org/10.34763/jmotherandchild.20232701.d-23-00061
Parole chiave
© 2023 Magdalena Rutkowska et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
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.