Clinical History.—This boy was born weighing approximately 1,000 gm. Because of severe respiratory distress he was transferred to the neonatal intensive care unit (Fig 1). He was critically ill. Treatment consisted of antibiotics, fluids, whole blood and sodium bicarbonate administered through an indwelling umbilical artery catheter. He was kept in oxygen and assisted mechanical ventilation became necessary. The values of blood gasses and other measures were carefully monitored. At approximately 48 hours of age his condition suddenly deteriorated. A chest roentgenogram was immediately obtained (Fig 2).
Denouement and Discussion
Massive Air Embolism
The roentgenologic examination showed air filling the heart, arterial, and venous systems. The infant died and postmortem examination showed severe respiratory distress syndrome; there was no obvious portal of entry for the air other than the umbilical artery catheter. For optimal survival of these sick infants intensive neonatal care is necessary, including mechanical assisted ventilation and umbilical