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Neonatal pneumopericardium: current management

E E Lawson, J B Gould, H W Taeusch

    Journal of Pediatric Surgery
    |April 1, 1980
    PubMed
    Summary
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    Neonatal pneumopericardium (PPC), a ventilator complication, can be asymptomatic or cause cardiac tamponade. Management ranges from observation to pericardiocentesis or catheter drainage, improving survival rates.

    Area of Science:

    • Neonatal Medicine
    • Pediatric Critical Care
    • Cardiology

    Background:

    • Neonatal pneumopericardium (PPC) is a recognized complication of mechanical ventilation in infants.
    • Current management strategies for PPC are not standardized, leading to controversy.

    Observation:

    • This study describes the clinical presentation of seven infants with PPC.
    • PPC was observed as an asymptomatic finding in some infants, not requiring intervention.
    • Other infants presented with cardiac tamponade, necessitating prompt diagnosis and treatment.

    Findings:

    • Simple needle pericardiocentesis is effective for managing PPC with cardiac tamponade in most cases.
    • A subset of infants required pericardial catheter placement for continuous air drainage when needle aspiration was insufficient.

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  • The mortality rate associated with PPC and tamponade, previously high (86% without therapy), is expected to decrease with contemporary management approaches.

    • Implications:

    • These findings suggest a tailored approach to PPC management based on clinical presentation.
    • Early diagnosis and appropriate intervention, such as pericardiocentesis, can significantly improve outcomes for neonates with PPC and tamponade.
    • Further research into optimal ventilator settings and management protocols may reduce the incidence and severity of PPC.