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August 1980

Massive Intracranial Air Embolism: A Complication of Mechanical Ventilation

Author Affiliations

Pediatric Education Iowa Methodist Medical Center 1200 Pleasant St Des Moines, IA 50308

Am J Dis Child. 1980;134(8):799-800. doi:10.1001/archpedi.1980.02130200067023

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