Tension pneumopericardium in a preterm infant without mechanical ventilation: a rare cause of cardiac arrest.

A preterm infant with a gestational age of 32 weeks developed a tension pneumopericardium during the second day of life. The infant was treated with nasal continuous positive airway pressure and was not mechanically ventilated before pneumopericardium occurred. After emergency pericardiocentesis, two recurrences of pneumopericardium without clinical deterioration were diagnosed by X-ray during a 2-d observation period. A continuous pericardial drainage was positioned and was successfully removed on the seventh day of life after weaning from the ventilator. Tension pneumopericardium may occur even in non-ventilated newborns and should be considered as a rare but important differential diagnosis of cardiac arrest.