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August 1980, Vol 134, No. 8 >
Article | August 1980

Massive Intracranial Air Embolism: A Complication of Mechanical Ventilation FREE

RAUL C. BANAGALE, MD
Am J Dis Child. 1980;134(8):799-800. doi:10.1001/archpedi.1980.02130200067023.
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Mechanical ventilation in the management of neonates with respiratory distress syndrome has been extended to include the very premature infant weighing less than 1,001 g.1 In spite of the new techniques and improved understanding of mechanical ventilation, there have been a number of complications.2-5 These include pneumothorax, pneumomediastinum, pneumopericardium, pneumoperitoneum, venous and/or arterial air embolism, pulmonary interstitial emphysema, pseudocyst formation, and bronchopulmonary dysplasia. This communication reports yet another complication, an unusual case of massive intracranial air embolism in a premature infant.

Report of a Case.—The patient was a 780-g male neonate, born spontaneously at 24 weeks' gestation. The Apgar scores at one and five minutes were 2 and 3, respectively. The infant was resuscitated by endotracheal intubation, manual bag ventilation with 1.0 fraction of inspired oxygen (Fio2), and administration of sodium bicarbonate, epinephrine, and 5% plasma protein fraction (human) through the umbilical arterial catheter. An initial

REFERENCES

1 +
Fitzhardinge PM, Pape K, Arstikaitis M, et al:  Mechanical ventilation of infants of less than 1,501 g birth weight: Health, growth and neurologic sequelae . J Pediatr 88:531-541, 1976;.
Link to Article
2 +
Bowen FW Jr, Chandra R, Avery GB:  Pulmonary interstitial emphysema with gas embolism in hyaline membrane disease . Am J Dis Child 126:117-118, 1973;.
3 +
Brown ZA, Clark JM, Jung AL:  Systemic gas embolus: A discussion of its pathogenesis in the neonate, with a review of the literature . Am J Dis Child 131:984-985, 1977;.
4 +
Chopra DR, Baker PC, Beam CW, et al:  Arteriovenous air embolism: A complication of mechanical ventilation in respiratory distress syndrome . Clin Pediatr 15:178-180, 1976;.
Link to Article
5 +
Weller MH:  The roentgenographic course and complications of hyaline membrane disease . Pediatr Clin North Am 20:381-406, 1973;.
6 +
Northway WH, Walls WL:  Gas in the fetal skull: A new sign of intrauterine fetal death . Am J Roentgenol 89:1080-1083, 1963;.
7 +
Henderson-Smart DJ:  Massive air embolism in a neonate with respiratory distress . Med J Aust 2:641-642, 1975;.
8 +
Quisling RG, Poznanski AK, Roloff DW, et al:  Postmortem gas accumulation in premature infants . Radiology 113:155-159, 1974;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Fitzhardinge PM, Pape K, Arstikaitis M, et al:  Mechanical ventilation of infants of less than 1,501 g birth weight: Health, growth and neurologic sequelae . J Pediatr 88:531-541, 1976;.
Link to Article
2 +
Bowen FW Jr, Chandra R, Avery GB:  Pulmonary interstitial emphysema with gas embolism in hyaline membrane disease . Am J Dis Child 126:117-118, 1973;.
3 +
Brown ZA, Clark JM, Jung AL:  Systemic gas embolus: A discussion of its pathogenesis in the neonate, with a review of the literature . Am J Dis Child 131:984-985, 1977;.
4 +
Chopra DR, Baker PC, Beam CW, et al:  Arteriovenous air embolism: A complication of mechanical ventilation in respiratory distress syndrome . Clin Pediatr 15:178-180, 1976;.
Link to Article
5 +
Weller MH:  The roentgenographic course and complications of hyaline membrane disease . Pediatr Clin North Am 20:381-406, 1973;.
6 +
Northway WH, Walls WL:  Gas in the fetal skull: A new sign of intrauterine fetal death . Am J Roentgenol 89:1080-1083, 1963;.
7 +
Henderson-Smart DJ:  Massive air embolism in a neonate with respiratory distress . Med J Aust 2:641-642, 1975;.
8 +
Quisling RG, Poznanski AK, Roloff DW, et al:  Postmortem gas accumulation in premature infants . Radiology 113:155-159, 1974;.

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