MASSIVE BILATERAL PNEUMOTHORAX WITH CARDIOPULMONARY ARREST DURING INTUBATION IN A NEONATE WITH MYELOMENINGOCELE: A CASE REPORT
Sami PNISHI, Feti AHMETI, Berat KEROLLI, Arben BISLIMI, Faton SERMAXHAJ, Leutrim PNISHI
Abstract
Myelomeningocele is presumed to be an acute neural tube malformation that is constantly related to hydrocephalus and other anomalies of the central nervous system. Airway management in neonatal patients, precisely during problematic intubation, may be associated with potentially fatal complications.
This article points out a patient of a 2-day-old neonate, born at term via cesarean section (38 weeks, 3560 g, APGAR 7/8), with lumbosacral myelomeningocele, hydrocephalus, and Dandy-Walker syndrome. It also presents repeated attempts before surgery, which was done during intubation, the patient developed a massive bilateral pneumothorax, leading to cardiopulmonary arrest. Extended resuscitation and emergency dual chest drainage were achieved, accomplishing stabilization of the patient.
Regardless of the initial critical condition and adverse effects during the intensive care stay, the patient improved without radiological evidence of ischemic brain trauma. On the side, a progress of operative closure of myelomeningocele is elaborated, albeit placement of a ventriculoperitoneal diversion was deferred due to the risk of infection.
There is a situation of bilateral pneumothorax during airway management in neonates, despite being rare, may quickly result in cardiopulmonary arrest and need prompt recognition and urgent intervention.
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