Pleuro-pericardial communication due to pigtail catheters in extreme preterm infants: Diagnosis and intervention

Area of Science:

• Neonatal Medicine
• Pediatric Surgery
• Respiratory Medicine

Background:

• Pneumothorax in preterm infants increases risks of chronic lung disease, intraventricular hemorrhage, and mortality.
• Tension pneumothorax management in mechanically ventilated preterm infants often requires thoracostomy if needle aspiration fails.
• Percutaneous pigtail catheter thoracostomy (PPCT) has largely replaced traditional chest tubes for tension pneumothorax in neonates.

Observation:

• This report details a rare complication of PPCT, previously only observed at autopsy.
• The complication occurred in an extremely preterm infant.

Findings:

• Prompt diagnosis and early management of this rare PPCT complication were achieved.
• PPCT is generally considered faster, requires less analgesia and training, and has fewer complications than traditional chest tubes.

Implications:

• Highlights the importance of recognizing rare complications associated with PPCT in vulnerable preterm infants.
• Emphasizes the need for vigilance and prompt intervention for successful management of PPCT complications.
• Contributes to the understanding of PPCT safety in extreme preterm neonates.