Abstract
Pneumopericardium (PPC) developed in 16 of 873 (2%) neonates receiving assisted ventilation; 14 were prematures with RDS requiring assisted ventilation within 12 hours. Pneumothorax (PNX) developed coincidentally in all but one. Pericardiocentesis (PCX) was performed in 11 of whom 7 (42%) survived. Cardiovascular parameters of heart rate (HR), arterial blood pressure (ABP), central venous pressure (CVP) and ECG were measured during 10 episodes of PPC. Early evidence of cardiac tamponade (CT) was moderate tachycardia and a sharp rise in CVP. This was followed by bradycardia and an abrupt decrease in pulse and ABP. Marked ST-segment depression with AV dissociation and 2° heart block were noted at this time. Following PCX, a rebound tachycardia, widening of pulse pressure, return of ABP to baseline and a gradual fall in CVP occurred in survivors while in those who died, bradycardia and hypotension persisted. PPC as a complication of assisted ventilation should be expected in a small number of infants with RDS. If the infant develops a pneumothorax, this risk is significantly increased. The diagnosis can be made before death by cardiovascular changes described. The condition can be successfully treated and adequacy of treatment can be assessed by the same factors used for diagnosis.
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Goldberg, R., Cabal, L., Siassi, B. et al. 965 PNEUMOPERICARDIUM: AN APPROACH TO DIAGNOSIS AND TREATMENT IN THE NEONATE. Pediatr Res 12 (Suppl 4), 524 (1978). https://doi.org/10.1203/00006450-197804001-00971
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DOI: https://doi.org/10.1203/00006450-197804001-00971
