[Pneumothorax in the background of cerebral hemorrhage in premature infants].

362 preterm newborns with birth weights ranging between 1 000 and 2 000 g were admitted to NICU of Kinderklinik Städtische Kliniken Kassel during Jan. 1978 and Dec. 1981. 160 babies (44%) needed breathing support (CNP, CPAP, IMV, IPPB). Pneumothorax occurred in 22 babies, 17 died. A severe cerebral hemorrhage was diagnosed in 12 (55%) of these babies on the basis of pathological and/or clinical findings. Cerebral hemorrhage followed pneumothorax. An air leakage syndrome was seen 15 times in 36 children with cerebral hemorrhage (42%). Pneumothorax causes not only intracranial hemodynamic changes, but also acute hypoxemia and slowly increasing hypercarbia, factors strongly contributory to cerebral hemorrhage in the premature baby. This point must be considered in the present discussion about high frequency ventilation for prevention of bronchopulmonary dysplasia. High frequency ventilation with presently traded ventilators is more correlated with alveolar rupture than low frequency ventilation.