neonatal pneumopericardium & pneumomediastinum

[Emilio Escobar]

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

[Stefan Johansson]

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.

 

[Nathan Sundgren]

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. 

[Manuel]

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.

[gmavrogeorgos]

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.

[Nathan Sundgren]

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???

[gmavrogeorgos]

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