Mayordomo-Colunga Juan, Rey Corsino, Medina Alberto, Concha Andrés
Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo Oviedo Spain.
J Med Case Rep. 2009 Jun 30;3:7390. doi: 10.4076/1752-1947-3-7390.
Two cases of iatrogenic tension pneumothorax in children are reported.
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.
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.
