Pulmonary artery embolism (PE) is a rare and life-threatening complication in the neonate. We describe two previously stable infants who incurred respiratory failure from PE. The first case is a late preterm infant with gastroschisis with autopsy confirmation of PE presumably as a result of a central venous line (CVL) with thromboembolism. The second case is an extreme low birth weight infant with sudden onset of respiratory failure, abnormal chest x-ray, disseminated intravascular coagulation (DIC), and echocardiographic confirmation of a thrombus at the junction of the superior vena cava and right atrium (SVC/RA) at the site of a previous CVL. This infant was successfully managed with thrombolytic therapy and anticoagulation. We suggest that PE be considered in an infant with a history of a CVL who presents with otherwise unexplained respiratory failure.
Pulmonary Embolism Presenting with Sudden Respiratory Failure in Two Previously Stable NeonatesPediatrics
Citation InformationWerthammer J, Pritt A, Reechi, L, Brown L, Heydarian M. Pulmonary embolism presenting with sudden respiratory failure in two previously stable neonates. J Neonatal-Perinatal Med. 2010;3:57–61.