Innovative application of ncpap in neonatal pseudo-pectus excavatum: a retrospective descriptive case series

Quantitative assessment methods for neonatal pseudo-pectus excavatum (PPE) remain limited, and evidence regarding early non-invasive management is insufficient. To describe the clinical changes in neonatal PPE following nasal continuous positive airway pressure (nCPAP) treatment and to explore a possible physiological mechanism underlying its use. A retrospective descriptive case series was conducted involving 12 neonates with PPE who received nCPAP treatment. Chest-wall funnel volume and the funnel volume index (FVI) were assessed before and after treatment using an ultra-light clay three-dimensional filling method. Clinical manifestations, nCPAP-related adverse events, and follow-up outcomes were recorded. The funnel volume and FVI before nCPAP were 2.00 ± 0.52mL and 0.80 ± 0.12mL/kg, respectively, while after nCPAP, they were 0.46 ± 0.20mL and 0.20 ± 0.11mL/kg, respectively.Compared before and after, the differences were statistically significant ( P < 0.001). The respiratory rate before nCPAP (52.89times/minute) was significantly different from that 24 h after nCPAP (50.22times/minute, P = 0.0026) and 24 h after weaning (49.50times/minute, P = 0.0002) at the three time points ( F = 13.04, P = 0.0002). After nCPAP treatment, chest-wall depression improved in all 12 infants. No serious adverse events or escalation of respiratory support occurred, although transient fluctuations in oxygen saturation were observed in a small number of infants. During the follow-up period of 10 months to 3 years, no deformity recurrence or progression to PE occurred. In this small retrospective case series, improvement in neonatal PPE was observed following nCPAP treatment. The ultra-light clay three-dimensional filling method may provide a simple and feasible exploratory approach for quantifying chest-wall depression.