Air Embolism in Neonates
Neonates are a high risk population for air embolism, and in particular cardiac air embolism. Although the clinical presentations of this event may vary, typical symptoms present as pallor, cyanosis, poor perfusion, bradycardia, and desaturation episodes which do not respond to positive pressure ventilation at 100%.
A cardiac air embolism is air that gets trapped in the heart and affects the heart’s function in mainly two ways. Air in the heart tends to migrate towards the right ventricular outflow tract (RVOT) which connects to the pulmonary artery. In doing so the air may become lodged in proximity to the pulmonary valve which can cause varying degrees of RVOT obstruction compromising the pulmonary blood flow as well as left ventricle preload. Depending on the severity of the obstruction, the cardiac air embolism may also cause varying degrees of right ventricular disruption and failure. Another effect a cardiac air embolism can have on the heart would be impeding the coronary blood flow and thereby causing an acute myocardial ischemia.
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