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

Wald, Martin; Kirchner, Lieselotte; Lawrenz, Karin; Amann, Gabriele

doi:10.1007/s00134-003-1681-7

Cited by 16 publications

(5 citation statements)

References 13 publications

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“…Air embolism in neonates and young infants due to peripheral intravenous infusion is exceedingly rare. We find only seven documented cases in the English-language literature (17)(18)(19)(20)(21). Only one of those involved a previously healthy infant as in this case (18).…”

Section: Discussionmentioning

confidence: 78%

Infant Death Due to Air Embolism from Peripheral Venous Infusion

Sowell

Lovelady

Brogdon

et al. 2006

Journal of Forensic Sciences

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An otherwise healthy male infant was brought to the hospital because the mother suspected superficial infection at the operative site 5 days after an inguinal hernia repair. He was admitted to the pediatric unit overnight to be evaluated by his surgeon the next morning. When a venous infusion of maintenance fluids was started, the patient immediately went into cardio-respiratory arrest and was pronounced dead after resuscitation efforts failed. Subsequently, air collections were found in both venous and arterial circulations, including the splenoportal system. Detailed review of the clinical presentation and course, laboratory results, radiological, and pathological findings, along with a review of pertinent literature provides an explanation for the death by air embolism. Apparent inconsistent findings both radiographically and at autopsy are resolved. The mechanism of distribution of air to both systemic and splenoportal circulation is discussed. We believe this to be only the eighth case reported in English-language literature of infantile death from peripheral venous infusion. In all age groups, we find only six other cases in the English-language literature of gas found concomitantly in both the systemic and portal venous systems.

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Section: Discussionmentioning

confidence: 78%

Infant Death Due to Air Embolism from Peripheral Venous Infusion

Sowell

Lovelady

Brogdon

et al. 2006

Journal of Forensic Sciences

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“…27,28 In premature infants, SAE is always due to respiratory-assisted ventilation, such as insertion of central venous lines, 12,28 intravenous injections during resuscitation, 22 and, most of all, long-standing mechanical high-pressure ventilation. [1][2][3][4][5][6][7][8][9][10][11]19,21,22,29 Moreover, it has also been reported in one full-term infant suffering from Figure 2 The first chest-abdomen X-ray taken (A) shows bilateral lung opacities, partially hyperlucent right-lower lobe, tip of the umbilical venous catheter slightly bent to the right above the diaphragm, and signs of free air within the liver. The second chest-abdomen X-ray (B) shows left pneumothorax, diffuse interstitial emphysema, and free air in hepatic, iliac, femoral, and popliteal veins as well as in the upper-arm veins and, bilaterally, the jugular veins.…”

Section: Discussionmentioning

confidence: 99%

“…Both SAE and pulmonary vein air embolism are rare, [1][2][3][4][5][7][8][9][10][11][12][13][18][19][20][21][22][23] and there are only a few reported patients who have survived these usually fatal complications. 4,5,18 In the surviving case reported by Kogutt, the patient had no clinical symptoms and the diagnosis was based on radiographic findings only, 4 and an infant with such a condition treated by Weiner et al survived 13 days.…”

Section: Discussionmentioning

confidence: 99%

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

Beluffi

Perotti

2009

Amer J Perinatol

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“…Embolization of air is also a consideration with IO infusions, just as with PIV and CVC infusion (Wald et al, 2003). Anatomic studies by Tarrow showed that air emboli are usually caught in the capillaries of the sternum during sternal infusion.…”

Section: Complicationsmentioning

confidence: 99%

Intraosseous vascular access: A review

Paxton

2012

Trauma

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Intraosseous cannulation is an increasingly common means of achieving vascular access for the administration of fluids and medications during the emergent resuscitation of both paediatric and adult patients. Improved tools and techniques for intraosseous vascular access have recently been developed, enabling the healthcare provider to choose from a wide range of devices and insertion sites. Despite its increasing popularity within the adult population, and decades of use in the paediatric population, questions remain regarding the safety and efficacy of intraosseous infusion. Although various potential complications of intraosseous cannulation have been theorized, few serious complications have been reported. This article aims to provide a review of the current literature on intraosseous vascular access, including discussion on the various intraosseous devices currently available in the market, the advantages and disadvantages of intraosseous access compared to conventional vascular access methods, complications of intraosseous cannulation and current recommendations on the use of this approach.

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

Abstract: The average amounts of air which had entered the closed system after 100 acts of syringe assembly and aqua administration were 1.84, 1.95, and 2.0 ml. This corresponds to an average volume of almost 0.02 ml per injection.

Cited by 16 publications

References 13 publications

Infant Death Due to Air Embolism from Peripheral Venous Infusion

Infant Death Due to Air Embolism from Peripheral Venous Infusion

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

Intraosseous vascular access: A review

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