Jordan G D, Jarrett R V, Garcia J, Frank C G, Pettett P G
Department of Pediatrics, Madigan Army Medical Center, Tacoma, Washington 98431.
Am J Perinatol. 1989 Jan;6(1):80-3. doi: 10.1055/s-2007-999551.
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.
新生儿肺静脉空气栓塞（由通气治疗引起）目前仍然几乎总是致命的。我们报告一例病例，该病例表明婴儿有可能在这种事件的即时心血管后果中存活下来；然而，我们证明栓子可延伸至中枢神经系统（CNS）作为相关后遗症发生，并且我们提供了这种潜在关键并发症的首次发表记录（头颅超声检查）。记录了我们患者最初（但正在消退）的全身性栓塞与其随后（且持续存在）的中枢神经系统事件之间的时间关系并讨论了其意义。基于这些观察结果，我们提醒中枢神经系统受累在临床上难以识别，并提示这种受累可能导致致命结局。重要的是，似乎有可能在未来病例中进行干预以改善结局，我们在这方面提出了建议。
