Intracardiac air - the 'hospital killer' identified? Case reports and review of the literature : original article
2003
Venous access is an essential part of caring for the sick
neonate. The primary problem with catheters, whether
peripherally or centrally placed, is the difficulty in
maintaining them, the development of phlebitis and systemic
infection, and fluid extravasation. A lesser known
complication is the development of venous air embolism
(VAE), as described in the 4 cases presented. We agree with
others that VAE in newborn infants may occur more
frequently than expected and emphasise the fact that it is
preventable and that careful attention must be given to the
techniques of preparing venous infusions. As health
professionals (medical and nursing) we should take a harder
line and regard these events as medically negligent until
proven otherwise. We should take full responsibility for
equipment, the connections, the infusate and the monitoring
thereof. Unfortunately, the prognosis for this condition remains
poor and it is unclear whether an increased awareness of this
condition would influence outcome. Manufacturers of
intravenous fluids should produce products devoid of air in
order to reduce the risk of venous air embolism.
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