Background: Pneumothorax is the most common air leak syndrome and far more frequent in the neonatal period than any other time of life. Objective: To evaluate the etiolngies of pneumothoraces in the neonatal intensive care unit (NICU). Methods: In a prospective study, barotrauma, secondary pulmonary infections, unskilled endotracheal intubation, asynchrony between the patients breathing and ventilator and ventilation with self-inflating bag were studied on 50 NICU patients of Mofid children hospital. Findings: Mean airway pressure was above the critical level in 18% of the cases. 72% of cases had pneumothoraces in the right side and 16% bilaterally. Asychrony was seen in 38.6% of the cases, secondary pulmonary infections in 46% and malposition of ET tube in 36%. Ventilation with manual bag was done in all cases. The bags lacked manometer and pop-off valve. Conclusion: Barotrauma had the main probable role in the etiology of pneumothoraces and is probably caused by self-inflating bags without pop-off valve and manometer.    

Background: Supraclavicular nerve block is a method for upper limb surgery in Anesthesiology. In this method that is common for supraclavicular block, injection anesthesia on the first rib and it has complications such as pneumothorax, phrenic never pulsy, infection, intra spinal injection. In this study injection with a 10 degree cephalic side as compared with the first rib in order to, decrease of complications was evaluated. Materials and methods: In this research with a interventional study on 100 patients injection was done with a 10 degree cephalic side to the first rib and incidence of these complications is 0% in the Z-test the statistical difference is significant. Results: Results showed that there was no any case of peneumothorax and phernic nerve pulsy, although these complications were 6% and 60% in control group. There was significant in two groups using Z-test (p<0.0001). Conclusions: Therefore in this method, incidence of pneumothorax and phrenic never pulsy is decreased. Suggested that this method and the other methods compare and use this method with more confidence.

Meconium-stained amniotic fluid (MSAF) occurs in approximately 5-20% of live births that meconium aspiration syndrome occurs in approximately 4-5% of these neonates after birth with breathing meconium goes to the small bronchial tree and clinical manifestation such as respiratory distress and tachypena, is present. Thease patients have high mortality and morbidity. For this reason, we studied two groups of infants with meconium stained fluid and compaired mortality and morbidity in two groups. One group was intubated and suction immediately after, and other group was not intubated. In this study, that was prospective and analytical cross-sectional, infants who were delivered with meconium-stained amniotic fluid (MSAF) throught a 3 years period (1996-1999) AkbarAbadi Hospital were studied. In this period 33037 infants were delivered and meconium-stained amniotic fluid (MSAF) occurred in 3254 (9.85%) of this live births. In 217 instance (6.67%) amniotic fluid was thick, in 188 (86.64%) of this infants the trachea was immediately. After birth intubated and suctioned. But unfortunately in 29 infants (13.36%). The trachea was not immediately after birth intubated and suctioned. In the intubated group complications included: Sepsis 17.55% (25 patients), pneumothorax 13.82% (26 patients), respiratory distress syndrome (RDS) 15.42% (29 patients), peresistent fetal circulation (PFC) 3.19% (6 patient). In 29 infants (13.36%) that we couldn’t intubated and suctioned, complications included: sepsis 10.34% (3 infants), pneumothorax 37.93% (11 infants), RDS 17.24% (5 infants), PFC 6.9% (2 infants). In all in intubated group complications were in 45.74% (86 infants) that 6.38% (12 infants) of this were died. In unintubated group, complications were seen in 72.41% (21 infants), that 13.79% (4 infants) were died. In this study intubation and suction immediately after birth in thick meconium-stained amniotic fluid decreased meconium Aspiration syndrome but increased it’s morbidity.

Introduction: Bronchogenic cysts are rare congenital lesions which originate from ventral foregut and most commonly originated in the central mediastinum. They rarely have symptoms and at the time of diagnosis they usually are large, infectious or complicated. In this study a case report of bronchogenic cyst is reported.Case: The patient to be presented is a 47 years old man with sudden onset of chest pain, severe dyspnea, tachypnea and decreasing right lung sounds. Symptoms of PNEUMOTORAX were observed in lung radiography. The patient was treated by inserting chest-tube, but there was no response to the treatment. Urgent thoracotomy was performed. A large single bronchogenic cyst was detected in the right lung parenchyma attached to intermediate bronchus. Complete resection was performed. According to the pathology report, pneumothorax was developed secondary to rupture of the bronchogenic cyst.Conclusion: Lung parenchyma is not a common area for developing bronchogenic cyst but it has special importance because of its severe complications. Since exact diagnosis is not always possible before surgery, it is necessary to perform resection in all suspicious cases.