1/15. Tension pneumopericardium caused by positive pressure ventilation complicating anaerobic pneumonia.A 22-year-old man was admitted with pneumonia. He was immediately intubated and positive pressure ventilation was initiated. Blood and sputum cultures showed bacteroides fragilis and corynebacterium sp., which were treated with metronidazole and clindamycin. Three weeks later his blood pressure suddenly dropped with an elevation of the central venous pressure. Chest X-ray revealed a pneumopericardium. A parasternal mediastinotomy with partial pericardiectomy was immediately performed. On opening the pericardium his blood pressure normalised. The patient gradually recovered and six weeks after admission he was extubated. Two weeks later he was discharged. A pneumopericardium without previous thorax trauma is very rare and early recognition is imperative because a tension pneumopericardium with cardiac tamponade may develop, as happened in this case. A tension pneumopericardium has to be treated with immediate pericardiocentesis followed by partial pericardiectomy to avoid recurrence.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/15. Tension pneumopericardium in an infant.pneumopericardium in newborns is most often a complication of mechanical ventilation and frequently results in fatal cardiac tamponade. We report the case of a mechanically ventilated 33-day-old full-term gestation infant with interstitial pneumonitis who developed tension pneumopericardium. Treatment includes lowering peak inspiratory pressure and decompressing the pericardial space with tube drainage following pericardiocentesis.- - - - - - - - - - ranking = 0.125keywords = pressure (Clic here for more details about this article) |
3/15. pneumopericardium in blunt chest trauma after high-speed motor vehicle accidents.pneumopericardium is the presence of air in the pericardial space. In adults, it may be seen in the context with severe blunt chest trauma, pneumothorax, pneumoperitoneum, or other causes of pneumomediastinum. The diagnosis is made by computed tomography scan of the thorax and abdomen that allows the additional detection of concomitant injuries. Possible causes of the pneumopericardium such as tracheobronchial or oesophageal tears have to be excluded by bronchoscopy or esophagogastroduodenoscopy. Usually, pneumopericardium is self-limiting requiring no specific therapy. However, a continuous monitoring of the electrocardiography and the blood pressure is necessary at an intermediate care unit. Tension pneumopericardium causing a life-threatening cardiac tamponade requires an immediate pericardial aspiration, the subsequent pericardial drainage via a pericardial window or emergent open subxyphoid approach to the pericardium.- - - - - - - - - - ranking = 0.125keywords = pressure (Clic here for more details about this article) |
4/15. A case report of the transport of an infant with a tension pneumopericardium.Neonatal pneumopericardium is a potentially fatal complication of positive-pressure ventilation and has become rare with the advent of surfactant replacement therapy. The clinical diagnosis, stabilization, treatment, and nursing care of an infant with pneumopericardium has not previously been discussed in the nursing literature. In this case report, delays in the recognition and definitive treatment of the pneumopericardium were encountered, resulting in the transport of an infant with a tension pneumopericardium and pneumoperitoneum. Root-cause analysis is used to identify contributing factors and examine system changes necessary to prevent the transport of another patient with a similar potentially life-threatening condition. pneumopericardium should be suspected in any infant with an acute deterioration, especially in the presence of normal, equal breath sounds and muffled heart sounds, because prompt recognition and definitive treatment may be life-saving.- - - - - - - - - - ranking = 0.125keywords = pressure (Clic here for more details about this article) |
5/15. cardiac tamponade due to pneumopericardium.We describe a newborn with acute respiratory distress syndrome, subjected to mechanical ventilatory assistance with high level of peak inspiratory pressure (PIP) and positive end expiratory pressure (PEEP), who developed cardiac tamponade due to pneumopericardium. Tension pneumopericardium produces the same physiological derangement as cardiac tamponade secondary to accumulated blood or other fluids. This life-threatening complication demands immediate diagnosis and treatment.- - - - - - - - - - ranking = 0.25keywords = pressure (Clic here for more details about this article) |
6/15. cardiac tamponade due to pneumopericardium.pneumopericardium is rare in acute asthma and cardiac tamponade has not been reported. The case is reported of a 20 year old asthmatic patient in whom assisted ventilation and high airway pressures resulted in tension pneumopericardium with clinical signs of cardiac tamponade that were relieved by pericardial aspiration.- - - - - - - - - - ranking = 0.125keywords = pressure (Clic here for more details about this article) |
7/15. Posttraumatic tension pneumopericardium: the "small heart" sign.Radiographic measurements of the cardiothoracic ratio in four adult victims of blunt thoracic trauma with pneumopericardium demonstrated a sudden, substantial decrease in the size of the cardiac silhouette, which was accompanied by pathophysiologic effects of cardiac tamponade. The sudden decrease in cardiac size could not be attributed to a decrease in intravascular volume or to changes in positive airway pressure. Following surgical relief of tension pneumopericardium, the cardiac size was restored to baseline dimensions and the hemodynamic effects of tamponade resolved. In the presence of pneumopericardium, the "small heart" sign may alert one to the presence of tension pneumopericardium and impending cardiac tamponade.- - - - - - - - - - ranking = 0.125keywords = pressure (Clic here for more details about this article) |
8/15. Tension pneumopericardium following blunt chest trauma.A 12-year-old victim of an automobile-pedestrian accident appeared to develop severely compromised cardiac output shortly after intubation and positive pressure ventilation. Anteroposterior and lateral chest films showed air within the pericardial sac. After pericardiocentesis and withdrawal of air, cardiac function improved markedly as evidenced by a rise in blood pressure and a slowing of the pulse. A catheter was left in the pericardial sac for several days. The patient remained hemodynamically stable throughout the hospital stay and was subsequently discharged. documentation of this degree of tamponade from air in the pericardium is quite uncommon.- - - - - - - - - - ranking = 0.25keywords = pressure (Clic here for more details about this article) |
9/15. pneumopericardium during continuous positive airway pressure in respiratory distress syndrome.We report a case of neonatal pneumopericardium as a complication of continuous positive airway pressure (CPAP) delivered for respiratory distress. pneumopericardium is the rarest neonatal air-block syndrome and is almost invariably preceded by other forms of barotrauma. There has been only one previous report of pneumopericardium complicating treatment with CPAP. In the present case there was no evidence of other forms of air block.- - - - - - - - - - ranking = 0.625keywords = pressure (Clic here for more details about this article) |
10/15. Intraoperative life-threatening emphysema associated with endotracheal intubation and air insufflation devices: report of two cases.Two cases of life-threatening body emphysema with decompensating pneumothoraces, pneumomediastinum, and pneumopericardium intraoperatively have been presented. The most likely cause was tracheal perforation combined with high pressure ventilation. Although subcutaneous emphysema and pneumomediastinum are self-limiting conditions with rapid recovery with conservative treatment, life-threatening complications may arise requiring prompt recognition and specific surgical management in order to save the patient's life.- - - - - - - - - - ranking = 0.125keywords = pressure (Clic here for more details about this article) |
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