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Journal of Forensic Sciences May 2017Venous air embolism occurs when air enters the venous system. The main causes of venous air embolism include medical procedures, neck and head trauma, and injuries of...
Venous air embolism occurs when air enters the venous system. The main causes of venous air embolism include medical procedures, neck and head trauma, and injuries of the genitals. Self-induced suicidal (and intentional) air embolism is extremely rare. The authors report a rare case of a suicidal air embolism committed using a self-made tool composed of a plastic bottle and an infusion set, injecting nearly 2000 mL of air into the cubital vein. The toxicological analysis suggested that midazolam, together with air, was also injected into the circulation using the same bottle and infusion set.
Topics: Aged; Embolism, Air; Humans; Infusions, Intravenous; Male; Suicide
PubMed: 27907236
DOI: 10.1111/1556-4029.13320 -
Diagnostic and Interventional Radiology... May 2023To quantitatively analyze the risk factors for air embolism following computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and qualitatively... (Meta-Analysis)
Meta-Analysis
To quantitatively analyze the risk factors for air embolism following computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and qualitatively review their characteristics. The databases of PubMed, Embase, Web of Science, Wanfang Data, VIP information, and China National Knowledge Infrastructure were searched on January 4, 2021, for studies reporting the occurrence of air embolisms following CT-guided PTNB. After study selection, data extraction, and quality assessment, the characteristics of the included cases were qualitatively and quantitatively analyzed. A total of 154 cases of air embolism following CT-guided PTNB were reported. The reported incidence was 0.06% to 4.80%, and 35 (22.73%) patients were asymptomatic. An unconscious or unresponsive state was the most common symptom (29.87%). Air was most commonly found in the left ventricle (44.81%), and 104 (67.53%) patients recovered without sequelae. Air location ( < 0.001), emphysema ( = 0.061), and cough ( = 0.076) were associated with clinical symptoms. Air location ( = 0.015) and symptoms ( < 0.001) were significantly associated with prognosis. Lesion location [odds ratio (OR): 1.85, = 0.017], lesion subtype (OR: 3.78, = 0.01), pneumothorax (OR: 2.16, = 0.003), hemorrhage (OR: 3.20, < 0.001), and lesions located above the left atrium (OR: 4.35, = 0.042) were significant risk factors for air embolism. Based on the current evidence, a subsolid lesion, being located in the lower lobe, the presence of pneumothorax or hemorrhage, and lesions located above the left atrium were significant risk factors for air embolism.
Topics: Humans; Pneumothorax; Embolism, Air; Biopsy, Needle; Lung; Risk Factors; Lung Neoplasms; Hemorrhage; Tomography, X-Ray Computed; Image-Guided Biopsy; Radiography, Interventional; Retrospective Studies
PubMed: 36994842
DOI: 10.4274/dir.2022.221187 -
Canadian Journal of Anaesthesia =... Sep 2018
Topics: Embolism, Air; Humans; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 29546677
DOI: 10.1007/s12630-018-1112-4 -
AJNR. American Journal of Neuroradiology 2014Diving-related decompression illness is classified into 2 main categories: arterial gas embolism and decompression sickness. The latter is further divided into types 1... (Review)
Review
Diving-related decompression illness is classified into 2 main categories: arterial gas embolism and decompression sickness. The latter is further divided into types 1 and 2, depending on the clinical presentation. MR imaging is currently the most accurate neuroimaging technique available for the detection of brain and spinal cord lesions in neurologic type 2 decompression sickness. Rapid bubble formation in tissues and the bloodstream during ascent is the basic pathophysiologic mechanism in decompression illness. These bubbles can damage the central nervous system through different mechanisms, namely arterial occlusion, venous obstruction, or in situ toxicity. Neuroimaging studies of decompression sickness have reported findings associated with each of these mechanisms: some typical results are summarized and illustrated in this article. We also review the limitations of previous work and make practical methodologic suggestions for future neuroimaging studies.
Topics: Brain Diseases; Decompression Sickness; Diving; Embolism, Air; Humans; Neuroimaging; Spinal Cord Diseases
PubMed: 24924550
DOI: 10.3174/ajnr.A4005 -
General Thoracic and Cardiovascular... Oct 2019Since the beginning of cardiac surgery, retained intracardiac air has been an important problem. While transesophageal echocardiography enabled to visualize the air and... (Review)
Review
Since the beginning of cardiac surgery, retained intracardiac air has been an important problem. While transesophageal echocardiography enabled to visualize the air and de-airing procedures have been routinely done, they appear to vary much among institutions not necessarily based on firm scientific evidence. Thus, "de-airing" was chosen as the theme of 2016 CVSAP (cardiovascular surgery and anesthesia and perfusion) symposium and a nation-wide questionnaire survey was carried out prior to it. This paper reports on its results and illustrate "the best of de-airing" based on literature review. The collection rate of the questionnaire survey was 77.9% (278/357) and 83.3% (85/102) from the major institutions of surgeons and anesthesiologists, respectively. More than 90% of both consider de-airing as important, since adverse events of air embolism were actually encountered including critical ones. Most routinely performed de-airing procedures are posture change, lung inflation and aspiration through the vent cannulae. Direct aspiration is performed in one-third of institutions. Carbon dioxide insufflation is performed in 82.5% of institutions (mostly 2-3 L/min). However, not a few surgeons are skeptical for its significance. While many surgeons are grateful for collaboration by anesthesiologists, some expect more information sharing between them. They also expect that clinical engineers understand "de-airing" better and operate the extracorporeal circulation system appropriately to avoid an occurrence of undesirable event. Some surgeons anticipated a convenient device for de-airing. Furthermore, some questions to be solved in the future were raised, including how meticulously the bubbles should be removed or how efficient carbon dioxide insufflation is.
Topics: Carbon Dioxide; Cardiac Surgical Procedures; Embolism, Air; Humans; Insufflation
PubMed: 31290000
DOI: 10.1007/s11748-019-01168-6 -
Journal of Neurosurgical Anesthesiology Apr 2023
Topics: Humans; Embolism, Air; Tomography, X-Ray Computed; Intracranial Embolism
PubMed: 35650683
DOI: 10.1097/ANA.0000000000000858 -
Medicina Intensiva Nov 2022
Topics: Humans; Embolism, Air; Extracorporeal Circulation
PubMed: 36089513
DOI: 10.1016/j.medine.2022.07.007 -
JACC. Clinical Electrophysiology Sep 2020Air embolisms can lead to lethal results; however, few reports have systemically investigated this issue. Of 348 consecutive patients with atrial fibrillation who... (Review)
Review
Air embolisms can lead to lethal results; however, few reports have systemically investigated this issue. Of 348 consecutive patients with atrial fibrillation who underwent cryoballoon ablation, procedures were performed conventionally in 251 patients. In the remaining 97 patients, a water bucket was used while inserting the cryoballoon into the sheath. A total of 10 coronary air embolisms with ST-segment elevation in the inferior leads were observed among 9 (2.6%) patients. Multiple air bubbles were identified in 2 patients on emergent coronary angiography. All recovered under conservative treatment without any sequela. The incidence decreased when using the water bucket (1 of 97 [1.03%] vs. 8 of 251 [3.2%], p = 0.454).
Topics: Atrial Fibrillation; Catheter Ablation; Cryosurgery; Embolism, Air; Humans; Pulmonary Veins; Treatment Outcome; Water
PubMed: 32972540
DOI: 10.1016/j.jacep.2020.07.012 -
CMAJ : Canadian Medical Association... Aug 2017
Topics: Contrast Media; Diagnosis, Differential; Embolism, Air; Female; Humans; Injections, Intravenous; Middle Aged; Pulmonary Embolism; Tomography, X-Ray Computed
PubMed: 28827438
DOI: 10.1503/cmaj.170265 -
The American Journal of Emergency... Jun 2023We report the case of an 84-years old female patient who developed cerebral air embolism in association with the indwelling hemodialysis central venous catheter....
We report the case of an 84-years old female patient who developed cerebral air embolism in association with the indwelling hemodialysis central venous catheter. Pneumocephalus, even though rare, should be included in the differential diagnosis of acute manifestation of neurologic deficits, especially in association with central venous access, surgical interventions or trauma, and requests prompt management. Brain computed tomography scanning remains the investigation of choice.
Topics: Humans; Female; Aged, 80 and over; Catheterization, Central Venous; Pneumocephalus; Coma; Tomography, X-Ray Computed; Embolism, Air
PubMed: 37005175
DOI: 10.1016/j.ajem.2023.03.046