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Nontraumatic tension pneumopericardium in nonventilated pediatric patients: a review.
- Source :
-
Journal of cardiac surgery [J Card Surg] 2019 Sep; Vol. 34 (9), pp. 829-836. Date of Electronic Publication: 2019 Jul 03. - Publication Year :
- 2019
-
Abstract
- Background and Aims: Pneumopericardium is a rare air leak syndrome caused by the abnormal presence of air in the pericardial sac, with a high risk of morbidity and mortality. It is clinically divided into nontension and tension pneumopericardium, with the latter resulting in a decreased cardiac output and circulatory failure. There are limited data regarding nontraumatic pneumopericardium in nonventilated pediatric patients. Therefore, we aimed to describe a case of tension pneumopericardium and review the available literature.<br />Methods: Case report and literature review of nontraumatic pneumopericardium in nonventilated pediatric patients.<br />Results: A 2-month-old infant developed cardiac tamponade secondary to tension pneumopericardium 11 days after cardiac surgery promptly resolved with pericardium drainage. We reviewed the literature on this topic and retrieved 50 cases, of which 72% were nontension whereas a minority were tension pneumopericardium (28%). Patients with tension pneumopericardium were mostly neonates (35.7% vs 22.2%), presented with an isolated air leak (64.3% vs 36.1%), and had a history of surgery (28.6% vs 8.3%) or hematological disease (28.6% vs 11.1%). In all nontension cases, treatment was conservative, whilst in all other cases, pericardiocentesis/pericardium drainage was carried out. There was a high survival rate (86.0%), which was lower in patients with tension pneumopericardium (71.4% vs 91.6%).<br />Conclusions: Pneumopericardium is a rare condition with a higher mortality rate in patients with tension pneumopericardium, which requires immediate diagnosis and treatment. In nonventilated patients, tension pneumopericardium occurred more frequently in neonates, as an isolated air leak, and in those with a history of surgery or hematological disease.<br /> (© 2019 Wiley Periodicals, Inc.)
- Subjects :
- Cardiac Surgical Procedures adverse effects
Cardiac Tamponade diagnosis
Cardiac Tamponade mortality
Heart Defects, Congenital surgery
Humans
Infant, Newborn
Male
Respiration, Artificial
Survival Rate trends
Cardiac Tamponade etiology
Drainage methods
Pneumopericardium complications
Pneumopericardium diagnosis
Pneumopericardium mortality
Postoperative Complications
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8191
- Volume :
- 34
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Journal of cardiac surgery
- Publication Type :
- Academic Journal
- Accession number :
- 31269314
- Full Text :
- https://doi.org/10.1111/jocs.14159