Iatrogenic tension pneumothorax in children: two case reports.
BACKGROUND
Two cases of iatrogenic tension pneumothorax in children are reported.


METHODS
Case 1: A 2-year-old boy with suspected brain death after suffering multiple trauma suddenly developed intense cyanosis, extreme bradycardia and generalized subcutaneous emphysema during apnea testing. He received advanced cardiopulmonary resuscitation and urgent bilateral needle thoracostomy. Case 2: A diagnostic-therapeutic flexible bronchoscopy was conducted on a 17-month-old girl, under sedation-analgesia with midazolam and ketamine. She very suddenly developed bradycardia, generalized cyanosis and cervical, thoracic and abdominal subcutaneous emphysema. Urgent needle decompression of both hemithoraces was performed.


CONCLUSIONS
In techniques where gas is introduced into a child's airway, it is vital to ensure its way out to avoid iatrogenic tension pneumothorax. Moreover, the equipment to perform an urgent needle thoracostomy should be readily available.
Mayordomo-Colunga
Juan
J
Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo Oviedo Spain.
Rey
Corsino
C
Medina
Alberto
A
Concha
Andrés
A