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Brief Report

Open Access

Mediastinal tube placement in a premature infant with cardiorespiratory derangement due to ventilator associated 

pneumomediastinum

  • SANDRO DESSARDO1
  • KRISTINA LAH TOMULIĆ1
  • NEVEN FRLETA1
  • NADA SINDIĆIĆ DESSARDO1

1Pediatric Intensive Care Unit, Department of Pediatrics, University Hospital Rijeka

DOI: 10.22514/SV41.042009.6 Vol.4,Issue 1,April 2009 pp.27-29

Published: 09 April 2009

*Corresponding Author(s): SANDRO DESSARDO E-mail: sandro.dessardo@medri.hr

Abstract

While mediastinal free air in the ventilated newborn is usually benign, tension pneumomediastinum can lead to further cardiorespiratory compromise due to the compression of mediastinal structures, including the heart and large blood vessels. The authors present a case of life-threatening pneumomediastinum in a ventilated preterm leading to abrupt onset of cardiorespiratory failure. An 8 French (Fr) drainage catheter was placed in the anterior mediastinum using the 2nd right intercostal space as an insertion site, with prompt hemodynamic improvement. A brief description of the drainage technique and a literature review is presented.

Keywords

hemodynamics, mechani-cal ventilation, pneumomediastinum, pneumothorax, thoracocentesis

Cite and Share

SANDRO DESSARDO,KRISTINA LAH TOMULIĆ,NEVEN FRLETA,NADA SINDIĆIĆ DESSARDO. Mediastinal tube placement in a premature infant with cardiorespiratory derangement due to ventilator associated pneumomediastinum. Signa Vitae. 2009. 4(1);27-29.

References

1. Hauri-Hohl A, Baenzigar O, Frey B. Pneumomediastinum in the neonatal and pediatric intensive care unit. Eur J Pediatr 2008;167:415-8.

2. Case CL, Oslizlok P, Fyfe D, Gilette PC. Neonatal pneumomediastinum with isolated mitral obstruction. Arch Dis Child 1990;65:56-8.

3. Livingston DH. Management of the surgical patient in MOSF. Am J Surg 1993;165(2A Suppl):8-13.

4. Turlapati KM, Spear RM, Peterson BM. Mediastinal tube placement in children with pneumomediastinum: Hemodynamic changes and description of technique. Ped Crit Care 1996;24(7):1257-60.

5. Chen CJ, Hsu ML, Diau GY, Fan HC, L SH, Lin WJ, et al. Neonatal spontaneous pneumomediastinum. J Med Sci 2003;23(1):49-52.

6. Beg MH, Reyazzudin MM. Traumatic tension pneumomediastinum mimicking cardiac tamponade. Thorax 1988;43:576-7.

7. Unger DL, Pifarre R. Tracheotomy for subcutaneous emphysema and pneumomediastinum complicating asthma. Chest 1972;61:691-2.

8. Thiebault DW, Lachman RS, Laul VR. Pulmonary interstitial emphysema, pneumomediastinum and pneumothorax. Am J Dis Chil 1973;126:611-4.

9. Chau HH, Kwok PC, Lai AK, Fan TW, Chan SC, Miu TY, et al. Percutaneous relief of tension pneumomediastinum in a child. Cardiovasc Intervent Radiol 2003;26(6):561-3.

10. Mohamed IS, Lee YH, Yamout SZ, Fakir S, Reynolds AM. Ultrasound guided percutaneous relief of tension pneumomediastinum in a 1-day old newborn. Arch Dis Child Fetal Neonatal Ed 2007;92(6):458.

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