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Updated: Aug 8, 2026

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
Published on: March 12, 2020
Neonatal pneumopericardium: analysis of ventilatory variables
High peak inspiratory pressure and prolonged inspiratory time during mechanical ventilation are linked to pneumopericardium in infants. Elevated mean airway pressure may be a key factor in preventing this serious complication.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Respiratory Physiology
Background:
- Pneumopericardium (PPC) is a rare but serious complication in infants receiving mechanical ventilation.
- Understanding the specific ventilator parameters associated with PPC is crucial for prevention and improved outcomes.
Purpose of the Study:
- To identify variables of assisted ventilation associated with the development of pneumopericardium in neonates.
Main Methods:
- Retrospective review of case reports of infants admitted to the NICU between 1971 and 1982 who developed PPC.
- Analysis of ventilator settings including Peak Inspiratory Pressure (PIP), Inspiratory Time (IT), Mean Airway Pressure (MAP), PEEP, and ventilator rate.
- Comparison of ventilator parameters before and after the occurrence of PPC.
Main Results:
- Of 19 infants, 16 had Respiratory Distress Syndrome (RDS).
- Significantly elevated PIP, IT, and MAP were observed immediately preceding PPC development.
- Lower MAP after the event in non-survivors suggested that reducing airway pressure does not improve survival.
Conclusions:
- High PIP, prolonged IT, and elevated MAP are associated with PPC in infants on mechanical ventilation.
- Mean Airway Pressure (MAP) may be a more useful index for preventing barotrauma and pulmonary air leaks.
- Further research into ventilator strategies for preventing PPC is warranted.
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