Successful treatment with positive airway pressure ventilation for tension pneumopericardium after pericardiocentesis in a neonate: a case report

JA Clinical Reports

Hiroshi Morimatsu¹  Kazuyoshi Shimizu¹  Makiko Tani¹  Naohiro Shioji²  Tomoyuki Kanazawa²  Tatsuo Iwasaki² 

[1] Department of Anesthesiology and Resuscitology, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Japan;Department of Anesthesiology and Resuscitology, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, 700-8558, Okayama, Japan;

关键词: Pneumopericardium;    Pericardiocentesis;    Recurrent nerve palsy;    Pleural pressure;    Positive pressure ventilation;   

DOI  :  10.1186/s40981-020-00384-x

来源: Springer

【 摘 要 】

BackgroundPneumopericardium in neonates is often associated with respiratory diseases, of which positive pressure ventilation (PPV) is an exacerbating factor. Here, we present a neonate case of pneumopericardium after cardiac surgery which was resolved after applying PPV.Case presentationA 28-day-old neonate with left recurrent nerve palsy after aortic reconstruction for interrupted aortic arch developed pericardial effusion. Pericardiocentesis was performed under general anesthesia, and a drainage tube was left in the pericardium. After extubation, stridor gradually exacerbated, following hemodynamic deterioration. A chest X-ray demonstrated pneumopericardium. Upper airway stenosis due to recurrent nerve palsy developed excessive negative pleural pressure, and air was drawn into pericardium via the insertion site of the drainage tube. After tracheal intubation and applying PPV, the pneumopericardium improved.ConclusionPPV does not always exacerbate pneumopericardium. In a patient with pericardial-atmosphere communication, increased inspiration effort can cause pneumopericardium, and PPV is a therapeutic option to alleviate the pneumopericardium.

【 授权许可】

CC BY