title: Starch accumulation in the lungs of two infants following positive ventilation.
abstract: Two infants in different nurseries were found with cardiopulmonary arrest. Cardiopulmonary resuscitation was undertaken immediately in both cases, but was unsuccessful. The cause of death in both infants was diagnosed as sudden unexpected death, probably sudden infant death syndrome, at postmortem investigations. Microscopic examination at autopsy showed the presence of starch granules in the lungs. These were probably introduced during tracheal or nasotracheal intubation for cardiopulmonary resuscitation from gloves sterilized with powdered cornstarch. In both cases cellular staining of foreign bodies was weak and there were few starch granules within macrophages. Our findings suggest that the detection of cornstarch in the lungs can be an artifact arising from surgical gloves used in resuscitation. This artifact may easily occur in infants because of their immature lungs and short respiratory tract. Non-powdered gloves should be worn instead of powdered gloves during tracheal intubation, especially in infants.
authors.affiliation: Department of Forensic Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan, unumlegm@tmd.ac.jp.
authors.forename: Kana
authors.initials: K
authors.lastname: Unuma
authors.forename: Kazuki
authors.initials: K
authors.lastname: Harada
authors.forename: Teruaki
authors.initials: T
authors.lastname: Oka
authors.forename: Koichi
authors.initials: K
authors.lastname: Uemura
mesh_terms: D016477:Artifacts; D001344:Autopsy; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002423:Cause of Death; D017809:Fatal Outcome; D005260:Female; D005932:Gloves, Surgical; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D008168:Lung / Q000737:chemistry* / Q000473:pathology*; D008297:Male; D013213:Starch / Q000032:analysis*; D013398:Sudden Infant Death / Q000473:pathology*
chemical_list: D013213:Starch