Massive gas embolism in a child
A 16-month-old girl who was hospitalized with pneumonia and treated with antibiotics died after the nurse erroneously connected her intravenous left forearm catheter to the oxygen supply. Autopsy revealed an impressive gas embolism in the left subclavian and brachiocephalic veins, reduced crepitus and enlarged lung volume, and congestion of the meningeal vessels with some areas showing small air bubbles. Dilation of the right atrium and the right ventricle with efflux under pressure of large amounts of air bubbles were observed. The coronary arteries and veins were filled with air bubbles intercalated with segments containing blood. After exclusion of putrefactive artifacts as the source of such a large amount of gas in the body death was considered to be due to a massive air embolism. While embolisms are well recognized in adults, these cases are only infrequently encountered in forensic practice in younger decedents.
KeywordsMassive gas embolism Child Neglect Iatrogenic Forensic autopsy
Ricardo Dinis-Oliveira acknowledges Fundação para a Ciência e a Tecnologia (FCT) for his Investigator Grant (IF/01147/2013).
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, and royalties.
Compliance with ethical standards
Conflict of interests
The authors declare that they have no conflict of interest. No writing assistance was used in the production of this manuscript.
All procedures were performed according to the ethical and legal standards of the institution.
- 3.Neuman TS, Thom SR. Physiology and medicine of hyperbaric oxygen therapy. Philadelphia: Saunders Elsevier; 2008.Google Scholar
- 16.McCarthy CJ, Behravesh S, Naidu SG, Air Embolism OR. Diagnosis, clinical management and outcomes. Diagnostics (Basel, Switzerland). 2017;7.Google Scholar
- 18.Varlet V, Smith F, de Froidmont S, Dominguez A, Rinaldi A, Augsburger M, et al. Innovative method for carbon dioxide determination in human postmortem cardiac gas samples using headspace-gas chromatography-mass spectrometry and stable labeled isotope as internal standard. Anal Chim Acta. 2013;784:42–6.CrossRefGoogle Scholar