The Annals of Thoracic Surgery, Vol 47, 274-277, Copyright © 1989 by The Society of Thoracic Surgeons
Neonatal pneumopericardium with high-frequency ventilation
RC Neal, DE Beck, VC Smith and DM Null
Department of General Surgery, Wilford Hall USAF Medical Center, Lackland Air Force Base, Texas.
Pneumopericardium is an uncommon condition in the neonate and has not, to
our knowledge, previously been reported in patients treated with
high-frequency ventilation. The results of such treatment in 8 neonates
seen in the Neonatal Intensive Care Unit, Wilford Hall USAF Medical Center,
San Antonio, Texas, are presented. The mean gestational age was 35 weeks,
and birth weight averaged 2.7 kg. The pneumopericardium developed while the
patients were on high-frequency ventilation, and the diagnosis was
confirmed with a chest radiogram. Treatment included pericardiocentesis
with a needle catheter followed by placement of a 10F to 14F chest tube
into the pericardial space. The pneumopericardium resolved in all 8
patients. Three of the newborns died of underlying disease; 5 survived and
were discharged from the hospital. Pneumopericardium in the neonate is a
life-threatening complication, and appropriate therapy includes drainage
with a pericardial tube placed under direct vision.
