Neonatal pneumopericardium

Y. W. Brans, M. Pitts and G. Cassady

Six cases of pneumopericardium in neonates with hyaline membrane disease were observed during a six-month period. Five babies were receiving positive inspiratory or expiratory pressure or both. All but one had other extra-alveolar air collections. In three cases, sudden decrease in PaO2 was the only recorded sign that led to diagnosis. Pericardial aspiration was performed in four babies; one died and three either survived or died later of unrelated disease. One neonate was not treated and died of other causes. Treatment was delayed in the sixth infant; the pneumopericardium disappeared spontaneously but soon reappeared and contributed to a fatal outcome, although a drainage catheter was inserted. This experience and review of other authors' observations suggest that prompt drainage by catheter and continuous suction is indicated.