Hello, everyone. Could you please provide me with management guidelines for neonatal pneumopericardium and pneumomediastinum? Thanks in advance

Hi Emilio,

unless the air leaks create severe (life-threat) symtoms, such as cardiac tamponade - let is resolve spontaneously. Pneumomediastinum - same strategy.

Sticking needles into things always has the risk of causing 1) damage and 2) inflammation/infection.

 

Agree with @Stefan Johansson. First priority is - is it a problem? If emergent then you might just have to go in blindly. In my one near emergency, I was able to get cardiology to use echo guided needle pericardiocentesis. 

I agree with Stephan and Nathan, Im from Mexico too Emilio, and unless there is a real emergency situation, we only observe, be carefully with your ventilator parameters, and any therapeutic decision ( specially pneumopericardium) it has to be ecochardiography guided.

An asymptomatic newborn was admitted from the postnatal ward, where they had an echo (as screening), and the cardiologist felt that something was funny and ordered a chest x-ray as shown! We did nothing and after 10 days it resolved spontaneously.

4 hours ago, gmavrogeorgos said:

An asymptomatic newborn was admitted from the postnatal ward, where they had an echo (as screening), and the cardiologist felt that something was funny and ordered a chest x-ray as shown! We did nothing and after 10 days it resolved spontaneously.

Impressive size! Any cause identified for this pneumopericardium? I think I understand spontaneous pneumothorax causes, but spontaneous pneumopericardium???

18 hours ago, Nathan Sundgren said:

Impressive size! Any cause identified for this pneumopericardium? I think I understand spontaneous pneumothorax causes, but spontaneous pneumopericardium???

No! no resuscitation at birth, breastfeeding on the postnatal ward! Medicine is full of surprises