Am J Perinatol 2009; 26(5): 393-397
DOI: 10.1055/s-0029-1214236
© Thieme Medical Publishers

Air Embolism in the Newborn: Rare Complication of Intensive Care Therapy in Children

Giampiero Beluffi1 , GianFranco Perotti2
  • 1Sezione di Radiologia Pediatrica, IRCCS Policlinico San Matteo, Pavia, Italy
  • 2Divisione di Patologia Neonatale e Terapia Intensive Neonatale, Fondazione IRCCS Policlino S. Matteo, Pavia, Italy
Further Information

Publication History

Publication Date:
06 March 2009 (online)

ABSTRACT

Systemic air embolism in neonates, either premature or full term, necessitating mechanical ventilation is a devastating and usually fatal condition. We describe three cases of this complication, two in mechanically assisted preterm babies, and one in a full-term dysmorphic patient. Causes and possible management are described.

REFERENCES

  • 1 Gwinn J L, Lee F A, Weinberger H D. Radiological case of the month: massive air embolism.  Am J Dis Child. 1973;  126 63-64
  • 2 Ponté C, Remy J, Lequien P. Spontaneous air embolism in the newborn: a complication of pulmonary interstitial emphysema.  Pediatr Radiol. 1974;  2 231-234
  • 3 Shook D R, Cram K B, Williams H J. Pulmonary venous air embolism in hyaline membrane disease.  Am J Roentgenol Radium Ther Nucl Med. 1975;  125 538-542
  • 4 Kogutt M S. Systemic air embolism secondary to respiratory therapy in the neonate: six cases including one survivor.  Am J Roentgenol. 1978;  131 425-429
  • 5 Oppermann H C, Wille L, Obladen M, Richter E. Systemic air embolism in the respiratory distress syndrome of the newborn.  Pediatr Radiol. 1979;  8 139-145
  • 6 Weiner J H, Kliegman R M, Fanaroff A A, Carlo W A. Pulmonary venous air embolism in the neonate.  Crit Care Med. 1986;  14 67-69
  • 7 Bollinger B, Vinther S. Systemic air embolism in the neonate.  Pediatr Radiol. 1988;  19 52
  • 8 Richter A, Tegtmeyer F K, Möller J. Air embolism and pulmonary interstitial emphysema in a preterm infant with hyaline membrane disease.  Pediatr Radiol. 1991;  21 521-522
  • 9 Sizun J, Giroux J D, Rubio S, Thoma M, Colin A, Alix D. Embolie gazeuse létale d'origine pulmonaire chez un nouveau-né atteinte de maladie des membranes hyalines (cas radiologique du mois).  Arch Fr Pediatr. 1992;  49 819-820
  • 10 Birenbaum H J, Armiger J. Neonatal radiology casebook. Massive systemic air embolism in a low birth weight infant.  J Perinatol. 1996;  16 142-143
  • 11 Shah V, Martin N. Systemic air embolism in respiratory distress syndrome.  Indian J Pediatr. 1996;  63 809-812
  • 12 Smith J, Els I. Intracardiac air: the “hospital killer” identified? Case reports and review of the literature.  S Afr Med J. 2003;  93 922-927
  • 13 Yikilmaz A, Lee E Y. Massive air embolism in a newborn.  Pediatr Radiol. 2007;  37 607
  • 14 Miller T. Systemic air embolism in necrotizing enterocolitis.  AJR Am J Roentgenol. 1979;  132 322
  • 15 Daneman A, Woodward S, de Silva M. The radiology of neonatal necrotizing enterocolitis (NEC) A review of 47 cases and the literature.  Pediatr Radiol. 1978;  7 70-77
  • 16 Mante M, Rossi J, Champey J C, Favier O. Aéroportie post-traumatique de l'enfant.  Ann Radiol (Paris). 1992;  35 222-224
  • 17 The International Neonatal Network . The CRIB (Clinical Risk Index for Babies) score: a tool for assessing initial neonatal risk and comparing performance of neonatal intensive care units.  Lancet. 1993;  342 193-198
  • 18 Savani R C, Merten D F, Brazy J E. Air embolism with survival in a neonate.  Pediatr Radiol. 1990;  20 480-482
  • 19 Kumar P, Ostrea Jr E M. Ventilatory management casebook. Systemic air embolism: a potential fatal complication of ventilator therapy.  J Perinatol. 1995;  15 341-343
  • 20 Laskey A L, Dyer C, Tobias J D. Venous air embolism during home infusion therapy.  Pediatrics. 2002;  109 E15
  • 21 Tan G H, Sussmane J B. Massive air embolism in a neonate with pulmonary hypoplasia.  N Engl J Med. 2002;  346 751
  • 22 Wald M, Kirchner L, Lawrenz K, Amann G. Fatal air embolism in an extremely low birth weight infant: can it be caused by intravenous injection during resuscitation?.  Intensive Care Med. 2003;  29 630-633
  • 23 Sowell M W, Lovelady C L, Brogdon B G, Wecht C H. Infant death due to air embolism from peripheral venous infusion.  J Forensic Sci. 2007;  52 183-186
  • 24 Daneman A, Abou-Reslan W, Jarrin J, Traubici J, Hellmann J. Sonographic appearance of cerebral vascular air embolism in neonates: report of two cases.  Can Assoc Radiol J. 2003;  54 114-117
  • 25 Al-Hathlol K, Al-Mane K, Al-Hathal M, Al-Tawil K, Abulaimoun B. Air emboli in the intracranial venous sinuses of neonates.  Am J Perinatol. 2002;  19 55-58
  • 26 Macklin M T, Macklin C C. Malignant interstitial emphysema of the lung and mediastinum as an important complication in many respiratory diseases and other conditions.  Medicine. 1944;  23 281-358
  • 27 Booth T N, Royal S A, Allen B A. Lymphatic air embolism: a new hypothesis regarding the pathogenesis of neonatal systemic air embolism.  Pediatr Radiol. 1995;  25 S220-S227
  • 28 Royal S A. Massive air embolism in a newborn.  Pediatr Radiol. 2007;  37 1060
  • 29 Leicht C H, Waldman J. Pulmonary air embolism in the pediatric patient undergoing central catheter placement. A report of two cases.  Anesthesiology. 1986;  64 519-521
  • 30 Quisling R G, Poznanski A K, Roloff D W, Borer R C. Postmortem gas accumulation in premature infants.  Radiology. 1974;  113 155-159
  • 31 Bennet R. Unequivocal radiological evidence of intra-uterine foetal death, including demonstration of gas formation within the foetal circulation: report of a case, and review of thirty-seven cases of foetal death.  Clin Radiol. 1960;  11 200-204
  • 32 Orebaugh S L. Venous air embolism: clinical and experimental considerations.  Crit Care Med. 1992;  20 1169-1177

Prof. Giampiero BeluffiM.D. 

Giampiero Viale Golgi

19 Pavia I-27100 Pavia, Italy

Email: g.beluffi@smatteo.pv.it