[Pneumopericardium due to thorax compression : Overlooked resuscitation injury].

[Pneumopericardium due to thorax compression : Overlooked resuscitation injury].
Anaesthesist. 2015 Oct 14;
Authors: Flentje M, Krüger M, Ruschulte H
Abstract
On postoperative day 15 after right upper lobectomy of a non-small cell lung cancer a 75-year-old patient developed bradycardia followed by asystole during hospitalization on the intensive care unit. After approximately 4 min of chest compressions, circulatory function was re-established but the patient suffered from tachycardia and required continuous vasopressor support. To exclude hypovolemia and assess contractility, transthoracic echocardiography (TTE) was conducted. During the TTE examination neither the intensive care physician nor the cardiologist on call could obtain usable images, which was explained by the lack of experience of both physicians with TTE. Both chest ultrasound and chest x-ray imaging did not reveal any signs of a pneumothorax. A small zone of increased transparency in the cardiac silhouette was not considered to be of pathological relevance. Slowly, the patient recovered. On the following day, a thoracic computed tomography (CT) scan showed an extensive pneumopericardium of the entire pericardium with a seam width of 3 cm. Because of the patient's clinical improvement, a decision for a conservative therapeutic approach was made and 24 h later the seam width was reduced to 2 cm and 9 days later it was no longer detectable. After a total stay of 24 ...

Source: Der Anaesthesist - October 14, 2015 Category: Anesthesiology Authors: Flentje M, Krüger M, Ruschulte H Tags: Anaesthesist Source Type: research