PNEUMOPERICARDIUM - AN UNUSUAL CAUSE FOR CARDIAC-ARREST

A 1-year-old boy breathing via a T-piece system and recovering from me ningococcal septicaemia in the intensive care unit suffered a severe b out of coughing and developed bilateral pneumothoraces and tension pne umopericardium resulting in electromechanical dissociation and asystol e. Conventional cardiopulmonary resuscitation and adrenaline boluses w ere unsuccessful. Administration of 20 ml.kg(-1) of colloid and 3 mmol .kg(-1) of sodium bicarbonate solutions produced instantaneous return of cardiac output. The deleterious effects of cardiac tamponade appear ed to decrease with increasing cardiac filling pressures. The patient was managed conservatively and he made a full recovery with no signs o f residual neurological deficit.