Affiliations: Department of Pediatrics, Joan C. Edwards School of
Medicine, Marshall University, Huntington, WV, USA | Department of Pediatrics, University of Louisville
School of Medicine, Louisville, KY, USA | Department of Pathology, Joan C. Edwards School of
Medicine, Marshall University, Huntington, WV, USA
Note: [] Corresponding author: Dr. Joseph Werthammer, 1600 Medical
Center Drive, Ste. 3500, Huntington, WV 25701, USA. Tel.: +1 304 691 1371; Fax:
+1 304 691 1375; E-mail: Werthammer@marshall.edu
Abstract: 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 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.
Keywords: Pulmonary embolism, respiratory failure, thromboembolism, central venous line
