Fatal Air Embolism as a Complication of Staphylococcal Pneumonia With Pneumatoceles

Zuhdi, Muhammed; Bradley, John S.; Spear, Robert M.; Peterson, Bradley M.

doi:10.1097/00006454-199509000-00018

Cited by 7 publications

(4 citation statements)

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“…A lesão determina passagem de ar para o espaço intersticial, com formação de cisto de paredes finas contendo ar. A pneumatocele pode romper e ocasionar pneumotórax hipertensivo, fístula broncopleural e empiema 41 .…”

Section: Pneumatoceleunclassified

Abordagem cirúrgica da efusão pleural parapneumônica e suas complicações

Fraga¹,

Kim

2002

J. Pediatr. (Rio J.)

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Objective: surgical treatment of parapneumonic pleural effusion in children is controversial. The type of intervention is based mainly on personal experience and on the small number of reported cases. This article aims at presenting a literature review and the authors' experience in the surgical management of parapneumonic pleural effusion in children.Sources: data were searched in the Medline and Lilacs databases.Summary of the findings: complicated parapneumonic effusion should be surgically drained if thoracentesis reveals the presence of pus, positive Gram stain or culture, or pH less than 7.0 or glucose less than 40 mg/dl. The surgical drainage depends on the stage of parapneumonic pleural effusion: at the acute stage closed thoracostomy drainage is enough; at the fibrinopurulent stage thoracoscopy is indicated; at organizational stage thoracotomy can be performed in children with stable anesthetic conditions, and open thoracostomy drainage should be used in patients in a poor state of health. Echography is very important to evaluate the staging of parapneumonic effusion.Conclusions: surgical treatment of complicated parapneumonic effusion should be done as early as possible, and the kind of procedure depends on the stage of pleural effusion. In children with complicated parapneumonic effusion echography is very important to evaluate the staging of parapneumonic effusion.J Pediatr (Rio J) 2002; 78 (Supl.2): S161-S170: pleural effusion, surgical drainage, surgery. ResumoObjetivo: o tratamento cirúrgico do derrame parapneumônico na criança é controverso, sendo a abordagem baseada fundamentalmente na experiência pessoal e no pequeno número de casos relatados. O objetivo deste artigo é o de apresentar uma revisão bibliográ-fica dos principais trabalhos e experiência dos autores no tratamento cirúrgico do derrame parapneumônico na criança. Fonte dos dados: foram utilizados dados de artigos científicos pesquisados através dos bancos de dados Medline e Lilacs.Síntese dos dados: o derrame parapneumônico tem indicação de drenagem cirúrgica quando apresenta, à toracocentese, aspecto purulento, bactéria no Gram ou cultura, e análise bioquímica com pH menor que 7,0 e glicose menor que 40mg/dl. A drenagem cirúrgica depende da fase do derrame. Na fase aguda, é suficiente a drenagem torácica fechada; na fase fibrinopurulenta, é indicada toracoscopia; na fase organizada, a toracotomia é realizada em crianças com condições anestésicas, e a pleurostomia, naquelas debilitadas e com estado geral comprometido. A ecografia é útil, e, na maioria das vezes, fundamental, para definir a fase do derrame pleural.Conclusões: o tratamento cirúrgico do derrame parapneumôni-co complicado deve ser feito o mais precocemente possível, e o tipo de procedimento a ser realizado depende da fase do derrame pleural. Nas crianças que necessitam de drenagem cirúrgica, a ecografia é fundamental, para determinar a fase evolutiva do derrame parapneumônico.J Pediatr (Rio J) 2002; 78 (Supl.2): S161-S170: derrame pleural, drenagem postural, cirurg...

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Section: Pneumatoceleunclassified

Abordagem cirúrgica da efusão pleural parapneumônica e suas complicações

Fraga¹,

Kim

2002

J. Pediatr. (Rio J.)

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“…Systemic air embolism can also result from direct air entry into the arterial side of the pulmonary circulation, as may happen after long-term ventilation with high insufflation pressures, for example, in severe hyaline membrane disease [4,5]. A causal relationship with staphylococcal pneumonia has also been suggested [6]. Spontaneous air embolism can take origin from fistulas between airways and pulmonary vessels.…”

Section: Discussionmentioning

confidence: 99%

Fatal air embolism in an extremely low birth weight infant: can it be caused by intravenous injections during resuscitation?

et al. 2003

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“…Rarely, fatal complications such as air embolism have been described. 4 Although PIE will spontaneously regress over time, in ventilated infants in tervention is often necessary to avoid further lung injury, cardiovascular compromise, or fatal complications.…”

Section: Discussionmentioning

confidence: 99%

“…3 The presence of air in the interstitium or perivascular tissue of the lung impairs pulmonary function and in extreme cases may lead to fatal complications such as air embolism. 4 PIE is driven by the necessity to maintain adequate gas exchange in the presence of air trapping and failing lung function. Increasing ventilator pressures to support gas exchange promotes further accumulation of interstitial air and pulmonary compromise, and failure to break this cycle is associated with significant morbidity.…”

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confidence: 99%

Unilateral Pulmonary Interstitial Emphysema Following Pneumonia in a Preterm Infant Successfully Treated with Prolonged Selective Bronchial Intubation

O'Donovan¹,

Wearden²,

Adams³

1999

Amer J Perinatol

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We describe a ventilated preterm infant (26 week's gestation) who developed severe right-sided pulmonary interstitial emphysema following Staphylococcus aureus pneumonia. Prolonged selective bronchial intubation (10 days) resulted in a marked clinical improvement and resolution of the emphysema. Resolution of unilateral pulmonary interstitial emphysema may require a longer course of selective bronchial intubation than currently recommended.

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Fatal Air Embolism as a Complication of Staphylococcal Pneumonia With Pneumatoceles

Cited by 7 publications

References 0 publications

Abordagem cirúrgica da efusão pleural parapneumônica e suas complicações

Abordagem cirúrgica da efusão pleural parapneumônica e suas complicações

Fatal air embolism in an extremely low birth weight infant: can it be caused by intravenous injections during resuscitation?

Unilateral Pulmonary Interstitial Emphysema Following Pneumonia in a Preterm Infant Successfully Treated with Prolonged Selective Bronchial Intubation

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