Neonatal pneumopericardium with high-frequency ventilation.

Pneumopericardium is an uncommon condition in the neonate and has not, to our knowledge, previously been reported in patients treated with high-frequency ventilation. The results of such treatment in 8 neonates seen in the Neonatal Intensive Care Unit, Wilford Hall USAF Medical Center, San Antonio, Texas, are presented. The mean gestational age was 35 weeks, and birth weight averaged 2.7 kg. The pneumopericardium developed while the patients were on high-frequency ventilation, and the diagnosis was confirmed with a chest radiogram. Treatment included pericardiocentesis with a needle catheter followed by placement of a 10F to 14F chest tube into the pericardial space. The pneumopericardium resolved in all 8 patients. Three of the newborns died of underlying disease; 5 survived and were discharged from the hospital. Pneumopericardium in the neonate is a life-threatening complication, and appropriate therapy includes drainage with a pericardial tube placed under direct vision.