NEONATAL PNEUMOPERICARDIUM

Cases (6) of pneumopericardium in neonates with hyaline membrane disease were observed during a 6-mo. period. Five babies were receiving positive inspiratory or expiratory pressure or both. All but 1 had other extra-alveolar air collections. In 3 cases, sudden decrease in arterial O2 tension was the only recorded sign that led to diagnosis. Pericardial aspiration was performed in 4 babies; 1 died and 3 either survived or died later of unrelated disease. One neonate was not treated and died of other causes. Treatment was delayed in the 6th 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 observations suggest that prompt drainage by catheter and continuous suction is indicated.