Two Cases of Tension Pneumopericardium in Mechanically Ventilated Preterm Infants.

Maeng,  Se Hyun; Seo,  Hyun Joo; Shin,  Jeonghee; Jung,  Jimi; Kim,  Jin Kyu; Yoo,  Hye Soo; Ahn,  So Yoon; Kim,  Eun Sun; Chang,  Yun Sil; Park,  Won Soon

doi:2011.18.1.153

Neonatal Med > Volume 18(1); 2011 > Article

Case Report

Journal of the Korean Society of Neonatology 2011;18(1):153-157.
DOI: https://doi.org/10.5385/jksn.2011.18.1.153 Published online May 15, 2011.

Two Cases of Tension Pneumopericardium in Mechanically Ventilated Preterm Infants.

Se Hyun Maeng, Hyun Joo Seo, Jeonghee Shin, Jimi Jung, Jin Kyu Kim, Hye Soo Yoo, So Yoon Ahn, Eun Sun Kim, Yun Sil Chang, Won Soon Park

¹Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wonspark@skku.edu
²Department of Pediatrics, Myongji Hospital, Kwandong University School of Medicine, Goyang, Korea.

Abstract

Pneumopericardium is a rare form of neonatal air leakage. Tension pneumopericardium is much more infrequent, but can cause a cardiovascular deterioration with high mortality up to 80% and neurodevelopmental morbidity in half of the cases. We report two cases of preterm infants who successfully recovered from tension pneumopericardium that developed during mechanical ventilator assistance. The patients displayed a sudden increase in oxygen demand and subsequent cardiovascular deterioration. Immediate needle aspiration of the pneumopericardium performed after checking X-ray images rescued each of patient. Since the clinical symptoms are non-specific, clinicians' suspicion is most important when patients show sudden refractory cardiovascular collapse, especially in ventilator-assisted neonates. This life threatening complication demands instant diagnosis and intervention.

Key Words: Pneumopericardium; Preterm infant; Mechanical ventilator