ABSTRACT
Neonatal pulmonary venous air embolism (arising as a consequence of ventilator therapy) remains at present an almost invariably fatal occurrence. We present a case that illustrates that it is possible for an infant to survive the immediate cardiovascular consequences of such an event; however, we demonstrate that embolic extension into the central nervous system (CNS) can occur as an associated sequela, and we offer the first published documentation (cranial ultrasonography) of this potentially pivotal complication. The temporal relationships between our patient's initial (but resolving) systemic embolism and his subsequent (and persistent) CNS event are documented and the implications discussed. Based on these observations, we caution that CNS involvement is difficult to recognize clinically and suggest that such involvement may contribute to a fatal outcome. Importantly, it appears that it may be possible to intervene in future cases to improve outcome, and we offer suggestions in this regard.
Subject(s)
Embolism, Air/etiology , Intracranial Embolism and Thrombosis/etiology , Respiratory Distress Syndrome, Newborn/therapy , Ventilators, Mechanical/adverse effects , Embolism, Air/diagnosis , Humans , Infant, Newborn , Intracranial Embolism and Thrombosis/diagnosis , Male , UltrasonographySubject(s)
Polycythemia/epidemiology , Birth Weight , Gestational Age , Hawaii , Humans , Infant, NewbornSubject(s)
Pyoderma/epidemiology , Staphylococcal Infections/epidemiology , Female , Humans , Infant, Newborn , Male , Prospective Studies , Sex FactorsSubject(s)
Erythropoietin/blood , Polycythemia/blood , Fetal Blood/analysis , Humans , Infant, NewbornABSTRACT
A review of the records and radiographs of 21 newborn infants with necrotizing enterocolitis and 10 control infants was performed to test the significance of the persistent loop sign in necrotizing enterocolitis. Twelve clinical and laboratory variables were compared with the persistent loop sign. None of the control infants and seven of the 21 study infants had a persistent loop sign. Four of the seven infants were proven to have necrotic bowel. All four died. Four of the 14 study patients without the persistent loop sign had necrotic bowel. Two of these four infants died. The findings of this study do not support the use of a persistent segmental loop of bowel as a single criterion for surgical intervention.
Subject(s)
Enterocolitis, Pseudomembranous/diagnostic imaging , Infant, Newborn, Diseases/diagnostic imaging , Enterocolitis, Pseudomembranous/surgery , Humans , Infant, Newborn , Infant, Newborn, Diseases/surgery , RadiographyABSTRACT
A case of neonatal hemoperitoneum secondary to umbilical artery catheterization is presented. The only sign of arterial laceration was a rapid accumulation of intraperitoneal fluid following placement of the catheter.
