Minimally invasive treatment of retrocardiac tension pneumomediastinum in an extremely low birth weight infant

Ponkowski, Michael J.; Yadav, Bhupender; Meagher, Elisabeth; Ho, Anthony; Vellody, Ranjith

doi:10.1007/s00247-020-04712-2

Cited by 2 publications

(6 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While cases of generic pneumomediastinum in young ages are widely described in the literature, we cannot say the same for the retrocardiac one, for which few and old manuscripts are reported. Indeed, the search on Pubmed using a keyword such as “retrocardiac OR posterior pneumomediastinum”; the limits of age, “birth—23 months”; and English language led to 5 results, while the search carried out with a keyword such as “pneumomediastinum” and the same limits led to 762 results, among which, 10 papers described retrocardiac pneumomediastinum [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…In all cases that are summarized in Table 1 , the RP occurred in the neonatal period [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Invasive mechanical ventilation was considered as the primary cause of RP in eight papers [ 11 , 12 , 13 , 16 , 18 , 19 , 20 , 21 ], although Rosenfeld et al reported other conditions such as hyaline membrane disease (HDM), hypoplastic lung (HL), and meconium aspiration (MA) as causes of RP in neonates [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most of the cases of RP reported in Table 1 described symptomatic leaks with frequent respiratory distress, which habitually resolved spontaneously [ 11 , 12 , 13 , 14 , 16 , 18 , 19 , 20 , 21 ]. Nevertheless, progressive air collection in the posterior mediastinum has also caused life-threatening situations such as cardiac tamponade [ 19 , 21 ] that required a prompt intervention with surgical drainage. In our case, it is likely that wheezing was caused by asthmatic bronchitis rather than RP.…”

Section: Discussionmentioning

confidence: 99%

“…In these cases, treatment is directed towards symptom relief (analgesics or oxygen administration to improve pain and decrease respiratory fatigue, respectively), and serial chest X-ray may be used to monitor the evolution until pneumomediastinum resolution [ 10 ]. However, some patients may develop malignant pneumomediastinum, secondary pneumothorax, or pneumoperitoneum undermining clinical stability, and therefore require prompt surgical drainage [ 18 , 19 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Retrocardiac Pneumomediastinum: Description of an Unusual Case and Review of Literature

et al. 2023

View full text Add to dashboard Cite

Retrocardiac pneumomediastinum (RP) is the consequence of air trapping in the inferior and posterior mediastinum. It is characterized by the presence of a right or left para-sagittal infrahilar oval or pyramidal air collection on a chest X-ray. It is usually detected in neonates because of alveolar rupture after invasive ventilation or invasive manoeuvres applied on airways or the digestive tract. A healthy child came to the emergency department (ED) for acute respiratory failure due to viral bronchiolitis when he was 2 months old. Because of his clinical condition, he underwent helmet continuous positive airway pressure (HCPAP). When the condition allowed, he was discharged and sent home. He was re-admitted into the hospital for asthmatic bronchitis 3 months later. A frontal chest X-ray taken during the second hospitalization showed an oval-shaped retrocardiac air lucency not previously detected. Differential diagnosis including digestive and lung malformations was made. Finally, the diagnosis of RP was made. We report an unusual case of retrocardiac pneumomediastinum in a 5-month-old male infant after the application of continuous positive pressure via a helmet. RP presentation after the administration of non-invasive ventilatory support beyond the neonatal age is unusual. Although surgical drainage is curative, conservative treatment can be considered in hemodynamically stable patients.

show abstract

Section: Discussionmentioning

confidence: 99%

“…In all cases that are summarized in Table 1 , the RP occurred in the neonatal period [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Retrocardiac Pneumomediastinum: Description of an Unusual Case and Review of Literature

et al. 2023

View full text Add to dashboard Cite

show abstract

Computed tomography imaging-guided parasternal approach drainage for children with tension pneumomediastinum: a case series

Hong,

Chen

et al. 2023

BMC Pediatr

View full text Add to dashboard Cite

Purpose Tension pneumomediastinum is a rare and dangerous complication in children that can be fatal, and timely detection and treatment are critical. The aim of this study was to evaluate the safety and feasibility of computed tomography (CT) imaging-guided parasternal approach drainage for tension pneumomediastinum in children. Methods From June 2018 to February 2023, we consecutively enrolled 19 children with tension pneumomediastinum in our institution. A pigtail catheter was inserted into the anterior mediastinum by a CT imaging-guided parasternal approach. The catheter was connected to a negative-pressure water seal bottle to drain the pneumomediastinum. Clinical data and outcomes were summarized. Results The mean age was 3.1 ± 3.4 years, the mean weight was 15 ± 9.1 kg, the mean procedure time was 11.8 ± 2.4 min, and the drainage time was 6.7 ± 3.4 days. No major complications were identified, such as haemothorax, catheter displacement, or mediastinal infection. Effective drainage was obtained in all patients as assessed by comparing images and ventilatory parameters, and no additional surgical treatment was needed. There was no recurrence during the follow-up, which was more than 2 months. In our data, two children with COVID-19 were discharged from the hospital after effective drainage and other clinical treatment. Conclusion CT-guided parasternal approach drainage is safe, minimally invasive, and effective for children with tension pneumomediastinum.

show abstract

Minimally invasive treatment of retrocardiac tension pneumomediastinum in an extremely low birth weight infant

Cited by 2 publications

References 8 publications

Retrocardiac Pneumomediastinum: Description of an Unusual Case and Review of Literature

Retrocardiac Pneumomediastinum: Description of an Unusual Case and Review of Literature

Computed tomography imaging-guided parasternal approach drainage for children with tension pneumomediastinum: a case series

Contact Info

Product

Resources

About