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Journal of Anaesthesiology, Clinical... 2019
PubMed: 31543604
DOI: 10.4103/joacp.JOACP_143_18 -
European Journal of Case Reports in... 2023Many cases of gas embolism-related stroke are preventable by following guidelines.Sealing the tract where central venous catheters have been removed with tissue glue...
Many cases of gas embolism-related stroke are preventable by following guidelines.Sealing the tract where central venous catheters have been removed with tissue glue prevents air entrainment into the vascular system.Early hyperbaric treatment is essential, and the location of the nearest hyperbaric unit should be known whenever invasive procedures are undertaken.
PubMed: 36970160
DOI: 10.12890/2023_003739 -
International Journal of... 2023Evidence suggests that aldehyde dehydrogenase 2 (ALDH2) offers protection against damage caused by oxidative stress in diverse rodent models. Nonetheless, the effect of...
OBJECTIVE
Evidence suggests that aldehyde dehydrogenase 2 (ALDH2) offers protection against damage caused by oxidative stress in diverse rodent models. Nonetheless, the effect of Alda-1, a compound that activates ALDH2, on acute lung injury (ALI) induced by air embolism (AE) remains unclear. The objective of this study was to explore the protective effects of Alda-1 in ALI induced by AE.
METHODS
A rat model of in situ isolated perfused lung was established to investigate AE-induced ALI. Air was infused into the pulmonary artery at 0.25 mL/min for 1 minute. Before inducing AE, different doses (10, 20, or 30 mg/kg) of Alda-1 were given through intraperitoneal injection. Pathological changes in lung tissue were assessed using hematoxylin-eosin staining. We performed Western blot analysis to assess the protein levels of ALDH2,4-hydroxy-trans-2-nonenal (4-HNE), Bcl-2, caspase-3, phosphatidylinositol 3-kinase (PI3K), Akt, IκB-α, and nuclear NF-κB.
RESULTS
Notably, AE results were demonstrated as harmful to the lungs, which is evidenced by intensified lung edema and disruption of lung tissue structure. Furthermore, AE caused a decrease in ALDH2 expression, increased accumulation of 4-HNE and MDA, infiltration of neutrophils, increased production of inflammatory cytokines, apoptosis, and upregulation of the PI3K/Akt and NF-κB signaling pathways within the lungs. Administration of a 20 mg/kg dose of Alda-1 alleviated the detrimental effects induced by AE.
CONCLUSION
Alda-1 shows promise in mitigating AE-induced ALI, possibly through the upregulation of ALDH2 expression and suppression of the PI3K/Akt and NF-κB signaling pathways. Further research is warranted to validate these findings and to explore their translational potential in human subjects.
Topics: Humans; Rats; Animals; Aldehyde Dehydrogenase, Mitochondrial; Embolism, Air; Proto-Oncogene Proteins c-akt; Phosphatidylinositol 3-Kinases; NF-kappa B; Acute Lung Injury; Lung
PubMed: 38113877
DOI: 10.1177/03946320231223005 -
Inflammation Feb 2021Excessive amounts of air can enter the lungs and cause air embolism (AE)-induced acute lung injury (ALI). Pulmonary AE can occur during diving, aviation, and iatrogenic...
Excessive amounts of air can enter the lungs and cause air embolism (AE)-induced acute lung injury (ALI). Pulmonary AE can occur during diving, aviation, and iatrogenic invasive procedures. AE-induced lung injury presents with severe hypoxia, pulmonary hypertension, microvascular hyper-permeability, and severe inflammatory responses. Pulmonary AE-induced ALI is a serious complication resulting in significant morbidity and mortality. Surfactant is abundant in the lungs and its function is to lower surface tension. Earlier studies have explored the beneficial effects of surfactant in ALI; however, none have investigated the role of surfactant in pulmonary AE-induced ALI. Therefore, we conducted this study to determine the effects of surfactant in pulmonary AE-induced ALI. Isolated-perfused rat lungs were used as a model of pulmonary AE. The animals were divided into four groups (n = 6 per group): sham, air embolism (AE), AE + surfactant (0.5 mg/kg), and AE+ surfactant (1 mg/kg). Surfactant pretreatment was administered before the induction of pulmonary AE. Pulmonary AE was induced by the infusion of 0.7 cc air through a pulmonary artery catheter. After induction of air, pulmonary AE was presented with pulmonary edema, pulmonary microvascular hyper-permeability, and lung inflammation with neutrophilic sequestration. Activation of NF-κB was observed, along with increased expression of pro-inflammatory cytokines, and Na-K-Cl cotransporter isoform 1 (NKCC1). Surfactant suppressed the activation of NF-κB and decreased the expression of pro-inflammatory cytokines and NKCC1, thereby attenuating AE-induced lung injury. Therefore, AE-induced ALI presented with pulmonary edema, microvascular hyper-permeability, and lung inflammation. Surfactant suppressed the expressions of NF-κB, pro-inflammatory cytokines, and NKCC1, thereby attenuating AE-induced lung injury.
Topics: Acute Lung Injury; Animals; Embolism, Air; Gene Expression Regulation; Male; NF-kappa B; Rats; Rats, Sprague-Dawley; Solute Carrier Family 12, Member 2; Surface-Active Agents
PubMed: 33089374
DOI: 10.1007/s10753-020-01266-1 -
Pneumologie (Stuttgart, Germany) Dec 2016
Topics: Aged; Diagnosis, Differential; Embolism, Air; Humans; Image-Guided Biopsy; Intracranial Embolism; Lung Neoplasms; Male; Radiography, Interventional; Treatment Outcome
PubMed: 27931064
DOI: 10.1055/s-0036-1596069 -
Frontiers in Immunology 2022Air embolism may complicate invasive medical procedures. Bubbles trigger complement C3-mediated cytokine release, coagulation, and platelet activation in human whole...
INTRODUCTION
Air embolism may complicate invasive medical procedures. Bubbles trigger complement C3-mediated cytokine release, coagulation, and platelet activation in human whole blood. Since these findings have not been verified , we aimed to examine the effects of air embolism in pigs on thromboinflammation.
METHODS
Forty-five landrace pigs, average 17 kg (range 8.5-30), underwent intravenous air infusion for 300 or 360 minutes (n=29) or served as sham (n=14). Fourteen pigs were excluded due to e.g. infections or persistent foramen ovale. Blood was analyzed for white blood cells (WBC), complement activation (C3a and terminal C5b-9 complement complex [TCC]), cytokines, and hemostatic parameters including thrombin-antithrombin (TAT) using immunoassays and rotational thromboelastometry (ROTEM). Lung tissue was analyzed for complement and cytokines using qPCR and immunoassays. Results are presented as medians with interquartile range.
RESULTS
In 24 pigs receiving air infusion, WBC increased from 17×10/L (10-24) to 28 (16-42) (p<0.001). C3a increased from 21 ng/mL (15-46) to 67 (39-84) (p<0.001), whereas TCC increased only modestly (p=0.02). TAT increased from 35 µg/mL (28-42) to 51 (38-89) (p=0.002). ROTEM changed during first 120 minutes: Clotting time decreased from 613 seconds (531-677) to 538 (399-620) (p=0.006), clot formation time decreased from 161 seconds (122-195) to 124 (83-162) (p=0.02) and α-angle increased from 62 degrees (57-68) to 68 (62-74) (p=0.02). In lungs from pigs receiving air compared to sham animals, C3a was 34 ng/mL (14-50) versus 4.1 (2.4-5.7) (p<0.001), whereas TCC was 0.3 CAU/mL (0.2-0.3) versus 0.2 (0.1-0.2) (p=0.02). Lung cytokines in pigs receiving air compared to sham animals were: IL-1β 302 pg/mL (190-437) versus 107 (66-120), IL-6 644 pg/mL (358-1094) versus 25 (23-30), IL-8 203 pg/mL (81-377) versus 21 (20-35), and TNF 113 pg/mL (96-147) versus 16 (13-22) (all p<0.001). Cytokine mRNA in lung tissue from pigs receiving air compared to sham animals increased 12-fold for IL-1β, 121-fold for IL-6, and 17-fold for IL-8 (all p<0.001).
CONCLUSION
Venous air embolism in pigs activated C3 without a corresponding C5 activation and triggered thromboinflammation, consistent with a C3-dependent mechanism. C3-inhibition might represent a therapeutic approach to attenuate this response.
Topics: Animals; Complement C3; Complement Membrane Attack Complex; Cytokines; Embolism, Air; Inflammation; Interleukin-6; Interleukin-8; Swine; Thromboinflammation; Thrombosis
PubMed: 35371063
DOI: 10.3389/fimmu.2022.839632 -
Canadian Association of Radiologists... May 2019When faced with characterization of a suspicious lung lesion, transthoracic needle biopsy (TTNB) is the standard technique used to retrieve a pathological specimen.... (Review)
Review
When faced with characterization of a suspicious lung lesion, transthoracic needle biopsy (TTNB) is the standard technique used to retrieve a pathological specimen. Usual complications reported for this intervention are pneumothorax, hemorrhage, air embolism, and tumor seeding. This pictorial essay illustrates imaging of these complications.
Topics: Biopsy, Needle; Embolism, Air; Hemorrhage; Humans; Lung; Lung Neoplasms; Neoplasm Seeding; Pneumothorax; Risk Factors; Tomography, X-Ray Computed
PubMed: 30635216
DOI: 10.1016/j.carj.2018.08.006 -
Clinical Medicine (London, England) Sep 2019
Topics: Atrial Fibrillation; Embolism, Air; Fistula; Humans; Pericardium
PubMed: 31530708
DOI: 10.7861/clinmedicine.19-5-431a -
The Journal of Extra-corporeal... Sep 2021
Topics: Arteries; Delivery of Health Care; Embolism, Air; Humans
PubMed: 34658416
DOI: 10.1182/ject-2100010 -
Neurology India 2023The introduction of air into cerebral venous or arterial circulation known as cerebral air embolism (CAE) is a rare clinical entity. CAE is commonly iatrogenic secondary...
The introduction of air into cerebral venous or arterial circulation known as cerebral air embolism (CAE) is a rare clinical entity. CAE is commonly iatrogenic secondary to central venous catheter (CVC) placement or removal, various endoscopic procedures, or trauma or surgical scenarios. Here we report a case of spontaneous CAE in an unusual scenario. A 71-year-old male presented to emergency after developing giddiness following a yoga session. His MRI showed air embolism in the posterior fossa along cerebellar folia, prepontine, and suprasellar cisterns and tracking superiorly along the tentorium cerebelli. CAE is a rare clinical entity. Our case had CAE as a complication of cholesteatoma and possibly got triggered due to change in air pressor dynamics during yoga session.
Topics: Male; Humans; Aged; Embolism, Air; Endoscopy; Magnetic Resonance Imaging
PubMed: 37635514
DOI: 10.4103/0028-3886.383877