Systemic air embolism in an extremely low birthweight infant treated with high-frequency oscillatory ventilation

An extremely low birthweight infant in whom systemic air embolism occurred during high-frequency oscillatory ventilation is reported. He was delivered at 25 weeks and 6 days gestation weighing 600 g. He was diagnosed as having respiratory distress syndrome and had intermittent mandatory ventilation. At 2 days of age, there was pulmonary hemorrhage and high-frequency oscillatory ventilation was 22 cmH2O. At 9 days of age, X-ray film revealed air in the intracardiac cavity and major systemic vessels. Systemic air embolism can occur in an extremely low birthweight infant having high-frequency oscillatory ventilation with a mean airway pressure of 22 cmH2O or higher.