ELİF ÖZALKAYA, Güner KARARTEKİN, Sevilay TOPÇUOĞLU, Abdulhamit TUTEN, Tülin GÖKMEN

Prematüre İnfantlarda Uzamış Kardiyopulmoner Resusitasyondan Sonra Gelişen Hava Embolisi

Sistemik hava embolisi yenidoğanda çoğunlukla idiopatik hava infüzyonu, nekrotizan enterokolit ve pulmoner kaçak sendromlarına bağlı gelişmektedir. 28 haftalık 1355 gram doğan kız bebekte postnatal 9. gününde klinik sepsise sekonder apne ve kardiyopulmoner arrest gelişti. 30 dk kardiyopulmoner resusite edilen bebeğin resusitasyon sonrası çekilen grafisinde ve ultrasonunda kranial, sistemik ve pulmoner vaskularitede hava saptandı. Resüsitasyon ile geri dönen hastanın uzun dönem izleminde hava embolisine sekonder kortikal kistik lokomalazi ve nekrotizan enterokolit gelişti. Entübe izlenen hasta 180. gün ex oldu. Biz bu olgu sunumunda uzamış reusitasyona bağlı sistemik hava embolisi gelişen prematureyi sunduk.

Air Embolism After Prolonged Cardiopulmonary Resuscitation in A Preterm Infant

Systemic air embolism develops in newborns mostly secondary to idiopathic air infusion, necrotizing enterocolitis and pulmonary air leak syndromes. A girl infant weighing 1355 g was born at gestational of 28 weeks. She developed apnea and cardiopulmonary arrest secondary to clinical sepsis at postnatal day 9. On radiography and ultrasonography of the premature infant following cardiopulmonary resuscitation for 30 minutes, air was detected in the cranial, systemic and pulmonary vascularity. At long-term followed up of the patient with return of spontaneous circulation with resuscitation, cortical cystic leukomalacia and necrotizing enterocolitis developed secondary to air embolism. The patient intubated was lost at the day 180 of her life. In this case report, we presented a preterm infant who developed systemic air embolism due to prolonged resuscitation.

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Blanco CE,Rietveld LA, Ruys JH. Systemic air embolism. A possible complication of artificial ventilation. Acta Paediatr Scand 1979 ; 68: 925-927.
Fenton TR, Bennett S, McIntosh N. Air embolism in ventilated very low birth weight infants. Arch Dis C hild 1988; 63 :541-543.
Koehne P, Huseman D, Walch E, Buhrer C. Diverse outcome after air embolism in nonventilated preterm infants. İntensive Care Med 2006;32:1674-1675.
Levy I, Mosseri R, Garty B. Peripheral intravenous infusion -another cause of air embolism. Acta Paediatr 1996;85:385- 386.
Miller T. Systemic air embolism in necrotizing enterocolitis. AJR Am Roentgenol 1979; 132: 322.
Qazi AQ, Haider ZA, Najam Y. Fatal systemic air embolism in a neonate after cardiopulmonary resuscitation. APSP J Case Rep 2015; 6:11.
Andriessen P, Halbertsma F, Lijnschoten VG, Weerdenburg H, Oetomo SB. Systemic air embolism after cardiopulmonary resuscitation in a preterm infant. Acta Paediatrica 2008:97; 822-826.
Buyukkaya R, Aydın Ö, Hakyemez B, Parlak M. Massive cerebrovascular air embolism during posttraumatic cardiopulmonary resuscitation. Am J Emerg Med. 2014 ;32:194.
Halbertsma FJJ, Mohns T, Bok AL, Niemarkt HJ. Prevelance of systemic air embolism after prolonged cardiopulmonary resuscitation in newborns: A pilot study. Resuscitation 2015; 93: 96-101.
Booth TN, Allen BA, Royal SA. Lymphatic air embolism a new hypothesis redarding the pathogenesis of neonatal systemic air embolism. Pediatr Radiol 1995; 25: 220-227.
Jobe AH, Hilman N, Polglase G, Kramer BW, Kallapur S, Pillow J. İnjury and inflammation from resuscitation of the preterm infant. Neonatology 2008; 94: 190-196.
Perlman JM, Wylie J, Kattwinkel J, Atkins LD, Chamedies I, Goldsmith JP, et. al. Ressucitation and emergency cardiovascular care science with treatment recommendations. Pediatrics 2010; 126: 1319-1344.