A case of severe hyaline membrane disease managed with positive end-expiratory pressure respiration is described. The infant died of massive systemic gas embolization. Gas embolism has been associated with high pressure in the lung that presumably causes alveolar rupture, interstitial gas dissection, and eventual embolization into the pulmonary veins. With the increasing use of high-pressure respirator systems, this rare complication may become more common.
Bowen FW, Chandra R, Avery GB. Pulmonary Interstitial Emphysema With Gas Embolism in Hyaline Membrane Disease. Am J Dis Child. 1973;126(1):117-118. doi:10.1001/archpedi.1973.02110190105023