Pneumopericardium in very low birth weight infants.
The objective of this study was to describe the incidence, neonatal correlates, and outcome of pneumopericardium (PPC) in very low birth weight (VLBW) < or = 1.5 kg infants. Forty-seven VLBW infants with a PPC, born during 1977 to 1989, were compared with a cohort of 1302 ventilated VLBW infants. PPC developed in 2% of 2389 VLBW infants and 3.5% of 1349 ventilated infants. The mean birth weight (1008 +/- 220 gm), and mean gestation (27 +/- 2 weeks) of the PPC cohort was similar to the control cohort. Thirty-two (68%) of the infants with PPC were male, compared with 691 (53%) of the ventilated infants (p < 0.05). Eight (17%) of the infants with PPC survived, compared with 780 (60%) of the control cohort (p < 0.00001). The oxygenation index significantly increased before PPC, and was significantly higher in nonsurvivors than survivors. Four (50%) of the PPC survivors had neurodevelopmental impairment at 20 months, compared with 35% of the control cohort. Pneumopericardium is a rare event with high morbidity and mortality. Clinicians should suspect this diagnosis in VLBW infants with a rising oxygenation index and subsequent acute deterioration.
Hook
B
B
Case Western Reserve University, Rainbow Babies and Childrens Hospital, Cleveland, OH 44106, USA.
Hack
M
M
Morrison
S
S
Borawski-Clark
E
E
Newman
N S
NS
Fanaroff
A
A
D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011026:Pneumopericardium / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D012121:Respiration, Artificial; D012307:Risk Factors