Department of Anesthesiology and Pain Medicine, Seoul Medical Center, Seoul, Korea.
Korean J Anesthesiol. 2010 Dec;59(6):420-4. doi: 10.4097/kjae.2010.59.6.420. Epub 2010 Dec 31.
Tension pneumothorax in newborns is a rare but life-threatening complication. We encountered a case of a full-term neonate with a breech presentation. An elective cesarean section was scheduled. Immediately after delivery, the newborn was found to be breathless with a heart rate <60/min. During intubation and cardiac massage, the patient's femoral artery and vein were accessed. The infantogram revealed a right side tension pneumothorax. A 22 gauge needle thoracentesis relieved the right side chest pressure and a closed thoracostomy was performed. The severe acidosis was corrected with sodium bicarbonate. The patient was managed in the neonatal intensive care unit, but died from uncorrectable acidosis. We report this case with a review of the relevant literature.
新生儿张力性气胸罕见但危及生命。我们遇到一例足月臀位分娩新生儿。择期行剖宫产术。胎儿娩出后即刻患儿出现呼吸困难,心率<60 次/分。行气管插管及心脏按压时,同时行股动、静脉置管。急查床旁胸片提示右侧张力性气胸。立即行 22 号针头胸腔穿刺排气,右侧胸腔压力缓解,行胸腔闭式引流术。患儿酸中毒严重,给予碳酸氢钠纠酸。患儿转入新生儿重症监护病房治疗,最终因酸中毒无法纠正而死亡。结合相关文献复习,报告此病例。