Postmortem gas accumulation in premature infants

Serial postmortem radiographs were taken of 22 infants with the idiopathic respiratory distress syndrome. All had umbilical artery catheters and had received intermittent positive pressure ventilation prior to death. Four of the 22 gave evidence of spontaneous gas accumulation within intravascular, intraperitoneal and cerebrospinal fluid spaces. In 3, gas accumulation was demonstrated within 25 min after death and progressively increased even though their umbilical catheters were removed immediately after death. Since physiologic gas accumulation can occur rapidly the significance of postmortem intravascular gas can be interpreted only if the interval between death and the radiographic exposure is known.