Published in:
01-10-2006 | Pediatric Correspondence
Diverse outcome after air embolism in nonventilated preterm infants
Published in: Intensive Care Medicine | Issue 10/2006
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We report three cases of air embolism in nonventilated preterm infants (gestational age 27–29 weeks) which were observed within a 3-year period in a tertiary neonatal intensive care unit [1]. All infants presented with a sudden life-threatening deterioration on days 12, 3, and 14 of life, respectively. In all cases early ultrasonography allowed the proper diagnosis of this acute condition. Significant intracerebral and intracardiac air was demonstrated in all cases, while intrahepatic air was present in only two subjects (Fig. 1). Ultrasound revealed gradual resolution of the typical hyperechoic lesions within 6–48 h of the acute event in all patients.
Fig. 1
Ultrasonography demonstrating the typical hyperechoic lesions of significant air emboli in multiple organs with distal shadowing. A Cerebral ultrasound scan (coronary axis) in patient 1 showing several small intraventricular and intracerebral bursts of echogenicity. B B-mode echocardiography in patient 1 in the parasternal long axis with coalescing echogenic particles visible in the interventricular septum and apex of the left ventricle. Movement of air bubbles was apparent in the cavity of the left ventricle during real time scanning. At the same time apical myocardial contractility of the left ventricle and flow velocity time integral of the aortic flow (AoVTI 7.8 cm) were compromised. C Ultrasound of the right kidney in patient 1 demonstrating paraparenchymal air as a bright echo. D B-mode echocardiography in patient 2 in the parasternal short axis with several air bubbles visible as marked increase in the echodensity of the subaortic interventricular septum. AV Aortic valve; MV mitral valve; TV tricuspid valve; LA left atrium; RA right atrium. E Cerebral ultrasound scan (right parasagittal axis) in patient 2 shows several small peri- and intraventricular bright lesions. F Abdominal ultrasound in patient 3 demonstrates a patchy appearance of the liver due to several scattered bright echoes throughout the liver parenchyma representing small air bubbles
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