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Anesthesiology Feb 1999Systemic air or gas embolism has been increasingly recognized as a complication of serious chest trauma and often presents with catastrophic circulatory and cerebral... (Review)
Review
Systemic air or gas embolism has been increasingly recognized as a complication of serious chest trauma and often presents with catastrophic circulatory and cerebral events. The classic findings are hemoptysis, sudden cardiac or cerebral dysfunction after initiation of PPV, air in retinal vessels, and air in arterial aspirations. The clinician must be wary of more subtle presentations. Several diagnostic tools (TEE, Doppler, CT) can detect intracardiac and cerebral air, but they may not be necessary to confirm the diagnosis of SAE. Cessation of SAE is essential for successful resuscitation. In those with unilateral lung injury, this can theoretically be achieved by isolating and ventilating the noninjured lung. Sole reliance on immediate thoracotomy for hilar clamping to stem the flow of gas emboli is a concept that needs to be challenged. Whether airway and ventilation interventions will eliminate, delay, or decrease the need for thoracotomy and improve the prognosis of SAE remains to be seen. There is little reported in the literature regarding such interventions. Airway management of a patient at risk for SAE should include a technique that can selectively ventilate each lung. Patients with bilateral sources of SAE may benefit from the avoidance of high airway pressures. Regional anesthesia should be considered when appropriate. HBOT is useful in managing cerebral air embolism and should be incorporated as soon as possible. Clinicians involved in trauma care must be familiar with SAE. By adopting a problem-based solution through innovative airway and ventilation management, anesthesiologists may significantly alter and improve the morbidity and mortality rate of SAE resulting from chest trauma.
Topics: Animals; Embolism, Air; Humans; Lung; Lung Injury; Radiography; Thoracic Injuries
PubMed: 9952165
DOI: 10.1097/00000542-199902000-00033 -
Critical Care Medicine Aug 1992To examine the existing literature concerning venous air embolism. Causes, pathophysiology, and management are emphasized. (Review)
Review
OBJECTIVE
To examine the existing literature concerning venous air embolism. Causes, pathophysiology, and management are emphasized.
DATA SOURCES
The literature that was reviewed was retrieved from the MEDLINE System under the headings "venous air embolism," "air embolism," "therapy of air embolism," "etiology of venous air embolism," and "pathophysiology of venous air embolism" for the years 1970 to 1991. A manual search, derived from the references of these papers, was performed to obtain relevant citations for the years preceding 1970.
STUDY SELECTION
Experimental (animal) data, case reports, case series, and clinical investigations are included.
CONCLUSIONS
Venous air embolism is an infrequent complication of invasive diagnostic and therapeutic maneuvers. The cardiovascular, pulmonary, and central nervous systems may all be affected, with severity ranging from no symptoms to immediate cardiovascular collapse. Therapeutic interventions include mechanical measures, such as positioning, withdrawal of air from the right atrium, and measures aimed at reducing bubble size. Hyperbaric oxygen therapy holds some promise in accomplishing the latter, but randomized, controlled trials demonstrating efficacy have yet to be performed.
Topics: Animals; Catheterization, Central Venous; Combined Modality Therapy; Diagnosis, Differential; Embolism, Air; Humans; Veins
PubMed: 1643897
DOI: 10.1097/00003246-199208000-00017 -
Urology Aug 2023
Topics: Humans; Embolism, Air; Urology
PubMed: 37302760
DOI: 10.1016/j.urology.2023.05.026 -
Canadian Journal of Anaesthesia =... Jan 1990
Topics: Anesthesia, General; Canada; Coroners and Medical Examiners; Embolism, Air; Humans; Monitoring, Physiologic
PubMed: 2278534
DOI: 10.1007/BF03007476 -
JACC. Cardiovascular Interventions Sep 2022
Topics: Cardiac Catheterization; Catheter Ablation; Embolism, Air; Humans; Mediastinal Emphysema; Mitral Valve Insufficiency; Treatment Outcome
PubMed: 36075649
DOI: 10.1016/j.jcin.2022.06.032 -
The Journal of the American Association... May 1997The world literature, including hospital and medicolegal case records, was reviewed to collate cases of venous air embolism resulting from the increasing number of... (Review)
Review
The world literature, including hospital and medicolegal case records, was reviewed to collate cases of venous air embolism resulting from the increasing number of operative hysteroscopies being performed. Seven women undergoing operative hysteroscopy for five different indications had clear-cut evidence of venous air embolism early in the course of the procedure. Five of these patients died. This complication is rare but devastating, resulting from traumatic opening into large uterine sinuses, especially with the patient in the Trendelenburg position, when the heart is below the level of the uterus. Several steps can be taken to try to prevent this problem.
Topics: Embolism, Air; Female; Humans; Hysteroscopy; Intraoperative Complications; Laparoscopy; Posture
PubMed: 9154793
DOI: 10.1016/s1074-3804(05)80235-x -
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 -
Anesthesiology Apr 1977
Topics: Embolism, Air; Posture; Radionuclide Imaging
PubMed: 842892
DOI: 10.1097/00000542-197704000-00018 -
Clinical Radiology Jul 2011Systemic arterial air embolism is a rarely encountered but much feared complication of percutaneous lung biopsy. We present a comprehensive review of iatrogenic air... (Review)
Review
Systemic arterial air embolism is a rarely encountered but much feared complication of percutaneous lung biopsy. We present a comprehensive review of iatrogenic air embolism post-lung biopsy, a complication that is often suboptimally managed. This review was inspired by our own institutional experience and we use this to demonstrate that excellent outcomes from this complication can be seen with prompt treatment using hyperbaric oxygen chamber therapy, after initial patient stabilization has been achieved. Pathophysiology, clinical features, and risk factors are reviewed and misconceptions regards venous versus arterial air embolism are examined. An algorithm is provided for radiologists to ensure suspected patients are appropriately managed with more favourable outcomes.
Topics: Arteries; Biopsy, Needle; Embolism, Air; Humans; Hyperbaric Oxygenation; Lung; Tomography, X-Ray Computed
PubMed: 21530954
DOI: 10.1016/j.crad.2011.03.005 -
Journal of Neurosurgical Anesthesiology Apr 2023
Topics: Humans; Embolism, Air; Wakefulness; Deep Brain Stimulation; Craniotomy; Brain
PubMed: 35389934
DOI: 10.1097/ANA.0000000000000844