Suspected case of venous air embolism in an infant undergoing hip arthrogram.
An otherwise well ten-week-old girl underwent an air contrast hip arthrogram and application of a hip spica for a developmentally dislocated hip. The child displayed signs consistent with venous air embolism after injection of 5 ml of air into the hip joint. These signs included a decrease in arterial haemoglobin oxygen saturation as measured by pulse oximetry, decreased end-tidal carbon dioxide level and tachycardia. The signs initially resolved, but the patient deteriorated with injection of a further 5 ml of air. The patient responded to cessation of injection and resuscitative measures. The infant remained well postoperatively. The need for the use of air to confirm intra-articular placement of the needle prior to injection of contrast during a hip arthrogram is questioned.
Sarantopoulos
S
S
Department of Anaesthesia, Austin Health, Melbourne, Victoria.
Lew
J
J
D001175:Arthrography / Q000009:adverse effects* / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D004618:Embolism, Air / Q000209:etiology*; D005260:Female; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging*; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D007270:Injections, Intra-Articular; D011029:Pneumoradiography / Q000009:adverse effects
D003287:Contrast Media