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Unsuccessful resuscitation of a preterm infant due to a pneumothorax and a masked tension pneumopericardium
Summary Pneumopericardium is the least common form of air leak in infants. A tension pneumopericardium is even more infrequent but associated with a very high mortality rate. We describe the case of an unsuccessful resuscitation in a preterm infant due to a pneumothorax and tension pneumopericardium...
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Published in: | Resuscitation 2008-08, Vol.78 (2), p.236-239 |
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creator | Cools, Bjorn Plaskie, Katleen Van de Vijver, Koen Suys, Bert |
description | Summary Pneumopericardium is the least common form of air leak in infants. A tension pneumopericardium is even more infrequent but associated with a very high mortality rate. We describe the case of an unsuccessful resuscitation in a preterm infant due to a pneumothorax and tension pneumopericardium. Despite relatively mild pressure ventilation the patient developed massive pulmonary interstitial emphysema. The extra-alveolar air spread from the interstitium towards the mediastinal space (Macklin effect) and caused a pneumothorax and pneumopericardium, which evolved towards a tension pneumopericardium after a traumatic mechanical procedure. The infant deteriorated acutely. Despite prompt pleural drainage there were no signs of recovery at any time. Postmortal examination revealed a tension pneumopericardium and massive interstitial pulmonary emphysema, which was not obvious on radiographical investigation. In cases of acute deterioration of a ventilated neonate, one should always rule out pneumothorax. If the patient does not recover after pleural drainage and cardiac resuscitation a (tension) pneumopericardium should be considered. |
doi_str_mv | 10.1016/j.resuscitation.2008.02.025 |
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A tension pneumopericardium is even more infrequent but associated with a very high mortality rate. We describe the case of an unsuccessful resuscitation in a preterm infant due to a pneumothorax and tension pneumopericardium. Despite relatively mild pressure ventilation the patient developed massive pulmonary interstitial emphysema. The extra-alveolar air spread from the interstitium towards the mediastinal space (Macklin effect) and caused a pneumothorax and pneumopericardium, which evolved towards a tension pneumopericardium after a traumatic mechanical procedure. The infant deteriorated acutely. Despite prompt pleural drainage there were no signs of recovery at any time. Postmortal examination revealed a tension pneumopericardium and massive interstitial pulmonary emphysema, which was not obvious on radiographical investigation. In cases of acute deterioration of a ventilated neonate, one should always rule out pneumothorax. If the patient does not recover after pleural drainage and cardiac resuscitation a (tension) pneumopericardium should be considered.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2008.02.025</identifier><identifier>PMID: 18485563</identifier><identifier>CODEN: RSUSBS</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiopulmonary resuscitation (CPR) ; Emergency ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Fatal Outcome ; Humans ; Infant, Newborn ; Intensive care medicine ; Male ; Medical sciences ; Neonatal resuscitation ; Pericardial tamponade ; Pneumopericardium ; Pneumopericardium - complications ; Pneumopericardium - therapy ; Pneumothorax ; Pneumothorax - complications ; Pneumothorax - therapy ; Pulmonary Emphysema - etiology ; Pulmonary Emphysema - therapy ; Resuscitation - methods</subject><ispartof>Resuscitation, 2008-08, Vol.78 (2), p.236-239</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2008 Elsevier Ireland Ltd</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-b6a2bdfd02e28ba01e4d05d072874890dc6dba96fbcc42fecf8cbc5a2cb4e82e3</citedby><cites>FETCH-LOGICAL-c532t-b6a2bdfd02e28ba01e4d05d072874890dc6dba96fbcc42fecf8cbc5a2cb4e82e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20567630$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18485563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cools, Bjorn</creatorcontrib><creatorcontrib>Plaskie, Katleen</creatorcontrib><creatorcontrib>Van de Vijver, Koen</creatorcontrib><creatorcontrib>Suys, Bert</creatorcontrib><title>Unsuccessful resuscitation of a preterm infant due to a pneumothorax and a masked tension pneumopericardium</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Summary Pneumopericardium is the least common form of air leak in infants. A tension pneumopericardium is even more infrequent but associated with a very high mortality rate. We describe the case of an unsuccessful resuscitation in a preterm infant due to a pneumothorax and tension pneumopericardium. Despite relatively mild pressure ventilation the patient developed massive pulmonary interstitial emphysema. The extra-alveolar air spread from the interstitium towards the mediastinal space (Macklin effect) and caused a pneumothorax and pneumopericardium, which evolved towards a tension pneumopericardium after a traumatic mechanical procedure. The infant deteriorated acutely. Despite prompt pleural drainage there were no signs of recovery at any time. Postmortal examination revealed a tension pneumopericardium and massive interstitial pulmonary emphysema, which was not obvious on radiographical investigation. In cases of acute deterioration of a ventilated neonate, one should always rule out pneumothorax. If the patient does not recover after pleural drainage and cardiac resuscitation a (tension) pneumopericardium should be considered.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiopulmonary resuscitation (CPR)</subject><subject>Emergency</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Fatal Outcome</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neonatal resuscitation</subject><subject>Pericardial tamponade</subject><subject>Pneumopericardium</subject><subject>Pneumopericardium - complications</subject><subject>Pneumopericardium - therapy</subject><subject>Pneumothorax</subject><subject>Pneumothorax - complications</subject><subject>Pneumothorax - therapy</subject><subject>Pulmonary Emphysema - etiology</subject><subject>Pulmonary Emphysema - therapy</subject><subject>Resuscitation - methods</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNqNkluLFDEQRoMo7rj6F6RB9G3G6qTTnUYQlmW9wIIPus8hnVQwM93JmIu4_940Myjrk1AQKM5XFQ5FyKsWdi20_dv9LmIqSbussgt-RwHEDmgt_ohsWjGwbcsHeEw2wAC2Ix_oBXmW0h4AGB-Hp-SiFZ3gvGcbcrjzqWiNKdkyNw8GN8E2qjlGzBiXxnmrfG5MwSaHte-xLCF_D1H9apQ3tbWodEDTZPRpjZ-II0anVTSuLM_JE6vmhC_O7yW5-3Dz7frT9vbLx8_XV7dbzRnN26lXdDLWAEUqJgUtdga4gYGKoRMjGN2bSY29nbTuqEVthZ40V1RPHQqK7JK8Oc09xvCjYMpycUnjPCuPoSTZj4xy3rEKvjuBOoaUIlp5jG5R8V62IFfXci8fKJGrawm0Fq_pl-c1ZVrQ_M2e5Vbg9RlQSavZRuW1S384CrwfegaVuzlxWKX8dBhlXYheo3ERdZYmuP_80Pt_5ujZ-Wp_PuA9pn0o0VfvspWpBuTX9TzW6wABdTSn7Df2wb4M</recordid><startdate>20080801</startdate><enddate>20080801</enddate><creator>Cools, Bjorn</creator><creator>Plaskie, Katleen</creator><creator>Van de Vijver, Koen</creator><creator>Suys, Bert</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080801</creationdate><title>Unsuccessful resuscitation of a preterm infant due to a pneumothorax and a masked tension pneumopericardium</title><author>Cools, Bjorn ; Plaskie, Katleen ; Van de Vijver, Koen ; Suys, Bert</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-b6a2bdfd02e28ba01e4d05d072874890dc6dba96fbcc42fecf8cbc5a2cb4e82e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiopulmonary resuscitation (CPR)</topic><topic>Emergency</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Fatal Outcome</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neonatal resuscitation</topic><topic>Pericardial tamponade</topic><topic>Pneumopericardium</topic><topic>Pneumopericardium - complications</topic><topic>Pneumopericardium - therapy</topic><topic>Pneumothorax</topic><topic>Pneumothorax - complications</topic><topic>Pneumothorax - therapy</topic><topic>Pulmonary Emphysema - etiology</topic><topic>Pulmonary Emphysema - therapy</topic><topic>Resuscitation - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cools, Bjorn</creatorcontrib><creatorcontrib>Plaskie, Katleen</creatorcontrib><creatorcontrib>Van de Vijver, Koen</creatorcontrib><creatorcontrib>Suys, Bert</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cools, Bjorn</au><au>Plaskie, Katleen</au><au>Van de Vijver, Koen</au><au>Suys, Bert</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unsuccessful resuscitation of a preterm infant due to a pneumothorax and a masked tension pneumopericardium</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>78</volume><issue>2</issue><spage>236</spage><epage>239</epage><pages>236-239</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><coden>RSUSBS</coden><abstract>Summary Pneumopericardium is the least common form of air leak in infants. A tension pneumopericardium is even more infrequent but associated with a very high mortality rate. We describe the case of an unsuccessful resuscitation in a preterm infant due to a pneumothorax and tension pneumopericardium. Despite relatively mild pressure ventilation the patient developed massive pulmonary interstitial emphysema. The extra-alveolar air spread from the interstitium towards the mediastinal space (Macklin effect) and caused a pneumothorax and pneumopericardium, which evolved towards a tension pneumopericardium after a traumatic mechanical procedure. The infant deteriorated acutely. Despite prompt pleural drainage there were no signs of recovery at any time. Postmortal examination revealed a tension pneumopericardium and massive interstitial pulmonary emphysema, which was not obvious on radiographical investigation. In cases of acute deterioration of a ventilated neonate, one should always rule out pneumothorax. If the patient does not recover after pleural drainage and cardiac resuscitation a (tension) pneumopericardium should be considered.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>18485563</pmid><doi>10.1016/j.resuscitation.2008.02.025</doi><tpages>4</tpages></addata></record> |
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subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiopulmonary resuscitation (CPR) Emergency Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Fatal Outcome Humans Infant, Newborn Intensive care medicine Male Medical sciences Neonatal resuscitation Pericardial tamponade Pneumopericardium Pneumopericardium - complications Pneumopericardium - therapy Pneumothorax Pneumothorax - complications Pneumothorax - therapy Pulmonary Emphysema - etiology Pulmonary Emphysema - therapy Resuscitation - methods |
title | Unsuccessful resuscitation of a preterm infant due to a pneumothorax and a masked tension pneumopericardium |
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