Abstract An 830-g boy was born to a 17-year-old, primigravida mother after 27 weeks' gestation. At the time of delivery, he had no spontaneous respirations and was admitted to the Newborn Intensive Care Unit, Ochsner Clinic, New Orleans. He was intubated, and ventilation therapy was begun by bag; Apgar scores were 4 and 6 at one and five minutes. Severe respiratory distress was present with grunting, intercostal retractions, and decreased breath sounds bilaterally. The chest roentgenograms (Fig 1) were obtained at that time. The infant was placed under a radiant warmer, and positive pressure ventilation therapy was begun with a respiratory rate of 16 per minute, a pressure of 20 cm H2O, and a forced inspiratory oxygen of 75%. His condition remained relatively stable over the first 48 hours. However, respiratory distress continued to worsen, and he required increased respirator support. At 3 days of age, he became severely References 1. Macklin CC: Transport of air along sheaths of pulmonic blood vessels from alveoli to mediastinum . Arch Intern Med 64:913-926, 1939.Crossref 2. Macklin MT, Macklin CC: Malignant interstitial emphysema of the lung and mediastinum as an important occult complication in many respiratory diseases and other conditions . Medicine 23:281-358, 1944.Crossref 3. Bowen FW, Chandra R, Avery GB: Pulmonary interstitial emphysema with gas embolism in hyaline membrane disease . Am J Dis Child 126:117-118, 1973. 4. Weller MH: The roentgenographic course and complications of hyaline membrane disease . Pediatr Clin North Am 20:381-406, 1973. 5. Mikity VG, Taber P: Complications in the treatment of the respiratory distress syndrome . Pediatr Clin North Am 20:419-431, 1973. 6. Chiu C, Golding MR, Linder JB, et al: Pulmonary venous air embolism: A hemodynamic reappraisal . Surgery 61:816-819, 1967. 7. Van Allen CM, Hrdina LS, Clark J: Air embolism from the pulmonary vein: A clinical and experimental study . Arch Surg 19:567-599, 1929.Crossref 8. Durant TM, Oppenheimer MJ, Webster MR, et al: Arterial air embolism . Am Heart J 38:481-500, 1949.Crossref 9. Shook DR, Cram KB, Williams JH: Pulmonary venous air embolism in hyaline membrane disease . AJR 125:538-542, 1975.Crossref 10. Vinstein AL, Gresham EL, Lim MO, et al: Pulmonary venous air embolism in hyaline membrane disease . Radiology 105:627-630, 1972. 11. Quisling RG, Poznanski AK, Roloff DW, et al: Postmortem gas accumulation in premature infants . Radiology 113:155-159, 1974.
American Journal of Diseases of Children – American Medical Association
Published: Oct 1, 1980
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