STARCH PARTICLE EMBOLI IN LUNGS OF NEONATES

Abstract

Particulate matter, mainly starch, has been described in airways of lungs of newborns at autopsy, and attributed to inhalation of the talc from surgical gloves used with suctioning. Using polarised light we have identified birefingent particles typical of starch in the lumina of small peripheral pulmonary vessels. A total of 137 babies were studied retrospectively. 13 (9.4%) infants were found to have intravascular starch particles. 9 of these had had cardiac catheterization and cardiovascular surgery (shunt procedures for pulmonary valve atresia in 6 of them). One further infant underwent cardiac bypass during tracheal surgery. 2 others had multiple general surgical procedures. Only one child had no surgery. Thus the incidence of cardiovascular intervention was 10/13 (76%). Of 124 babies without particles, 21 had cardiac catheterization and/or cardiovascular surgery (21/124 or 16%). Since the birefringent particles are found in vessels, the route of entry into lungs is probably via blood stream, and not the respiratory tract. The likely source of entry remains starch on surgical gloves. Identical particles were observed in suspension of fluid washed from gloves. Our findings indicate the need for more thorough decontamination of surgical gloves prior to procedures.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD