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      Neonatal Pneumopericardium in a Nonventilated Term Infant: A Case Report and Review of the Literature

      case-report
      Author(s): , ,
      Publication date (Electronic):
      Journal: Case Reports in Pediatrics
      Publisher: Hindawi

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          Abstract

          Neonatal pneumopericardium (PPC) is a rare form of neonatal air leak syndrome with high morbidity and mortality. Air leak syndrome in the newborn is usually associated with active resuscitation, respiratory distress syndrome, meconium aspiration syndrome, mechanical ventilation, or trauma associated with labour. Neonatal PPC can be associated with other air leak syndromes such as pneumomediastinum, pneumothorax, pneumoperitoneum, and subcutaneous and interstitial emphysema. Spontaneous PPC is a rare event in the neonatal period. We report a case of PPC in association with pneumothorax in a nonventilated term infant. The infant responded to thoracocentesis without the need for pericardiocentesis.

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          Impact of oxygen concentration on time to resolution of spontaneous pneumothorax in term infants: a population based cohort study

          Huma Shaireen, Yacov Rabi, Amy Metcalfe … (2014)
          Background Little evidence exists regarding the optimal concentration of oxygen to use in the treatment of term neonates with spontaneous pneumothorax (SP). The practice of using high oxygen concentrations to promote “nitrogen washout” still exists at many centers. The aim of this study was to identify the time to clinical resolution of SP in term neonates treated with high oxygen concentrations (HO: FiO2 ≥ 60%), moderate oxygen concentrations (MO: FiO2 < 60%) or room air (RA: FiO2 = 21%). Methods A population based cohort study that included all term neonates with radiologically confirmed spontaneous pneumothorax admitted to all neonatal intensive care units in Calgary, Alberta, Canada, within 72 hours of birth between 2006 and 2010. Newborns with congenital and chromosomal anomalies, meconium aspiration, respiratory distress syndrome, and transient tachypnea of newborn, pneumonia, tension pneumothorax requiring thoracocentesis or chest tube drainage or mechanical ventilation before the diagnosis of pneumothorax were excluded. The primary outcome was time to clinical resolution (hours) of SP. A Cox proportional hazards model was developed to assess differences in time to resolution of SP between treatment groups. Results Neonates were classified into three groups based on the treatment received: HO (n = 27), MO (n = 35) and RA (n = 30). There was no significant difference in time to resolution of SP between the three groups, median (range 25th-75th percentile) for HO = 12 hr (8–27), MO = 12 hr (5–24) and RA = 11 hr (4–24) (p = 0.50). A significant difference in time to resolution of SP was also not observed after adjusting for inhaled oxygen concentration [MO (a HR = 1.13, 95% CI 0.54-2.37); RA (a HR = 1.19, 95% CI 0.69-2.05)], gender (a HR = 0.87, 95% CI 0.53-1.43) and ACoRN respiratory score (a HR = 0.7, 95% CI 0.41-1.34). Conclusions Supplemental oxygen use or nitrogen washout was not associated with faster resolution of SP. Infants treated with room air remained stable and did not require supplemental oxygen at any point of their admission.
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            Spontaneous pneumopericardium in a healthy full-term neonate.

            Preeti K Suresh, Amit Tagare, Sandeep Kadam … (2011)
            Pneumopericardium is rare in neonates and might be of serious clinical significance. Neonatal pneumopericardium is usually a complication of mechanical ventilation in premature infants with respiratory distress syndrome. Here, the authors report a full-term neonate who developed spontaneous pneumopericardium which resolved spontaneously.
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              Neonatal pneumopericardium.

              T Burt, P Lester (1982)
              The clinical data and radiographs of 50 neonates with pneumopericardium (PPC) were reviewed. Most of these neonates were premature, low-birth-weight infants with hyaline membrane disease who required ventilatory assistance. The presence of other extraventilatory air prior to (or concurrent with) PPC, the use of cardiopulmonary resuscitation with intracardiac drug administration, and improper endotracheal tube placement were contributory factors. However, it was not possible to determine why some infants progressed to PPC and others, with similar disease and predisposing conditions, did not. The primary radiographic sign of PPC is the "halo" sign, which was apparent in 96% of these cases. When this sign was not present, other signs, such as the "pericardial line" sign, were helpful. The overall mortality was 72%. Thirty-three per cent of the fatalities were related to PPC; however, the long-term prognosis is probably more closely related to the severity of underlying lung disease or other complications than to PPC.
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                Author and article information

                Contributors
                Amuchou Singh Soraisham:
                ORCID: http://orcid.org/0000-0002-9815-8759
                Journal
                Journal ID (nlm-ta): Case Rep Pediatr
                Journal ID (iso-abbrev): Case Rep Pediatr
                Journal ID (publisher-id): CRIPE
                Title: Case Reports in Pediatrics
                Publisher: Hindawi
                ISSN (Print): 2090-6803
                ISSN (Electronic): 2090-6811
                Publication date (Print): 2017
                Publication date (Electronic): 21 December 2017
                Volume: 2017
                Electronic Location Identifier: 3149370
                Affiliations
                Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
                Author notes

                Academic Editor: Bernhard Resch

                Author information
                http://orcid.org/0000-0002-9815-8759
                Article
                DOI: 10.1155/2017/3149370
                PMC ID: 5752999
                PubMed ID: 29430316
                SO-VID: 973c82ec-b98c-4500-98fe-bfc7ed1558c1
                Copyright © Copyright © 2017 Smita Roychoudhury et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 6 October 2017
                Date revision received : 9 November 2017
                Date accepted : 19 November 2017
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Pediatrics
                Data availability:
                ScienceOpen disciplines: Pediatrics

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