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The Journal of Invasive Cardiology Aug 2019Coronary artery air embolism can be fatal if not proficiently managed. Vasospasm is said to be protective in that it breaks the larger air bubbles, as occurred in the...
Coronary artery air embolism can be fatal if not proficiently managed. Vasospasm is said to be protective in that it breaks the larger air bubbles, as occurred in the present case.
Topics: Angioplasty, Balloon, Coronary; Anterior Wall Myocardial Infarction; Coronary Angiography; Coronary Vessels; Drug-Eluting Stents; Embolism, Air; Humans; Male; Middle Aged
PubMed: 31368903
DOI: No ID Found -
European Radiology Apr 2021To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a...
OBJECTIVES
To determine the incidence, risk factors, and prognostic indicators of symptomatic air embolism after percutaneous transthoracic lung biopsy (PTLB) by conducting a systematic review and pooled analysis.
METHODS
We searched the EMBASE and OVID-MEDLINE databases to identify studies that dealt with air embolism after PTLB and had extractable outcomes. The incidence of air embolism was pooled using a random effects model, and the causes of heterogeneity were investigated. To analyze risk factors for symptomatic embolism and unfavorable outcomes, multivariate logistic regression analysis was performed.
RESULTS
The pooled incidence of symptomatic air embolism after PTLB was 0.08% (95% confidence interval [CI], 0.048-0.128%; I = 45%). In the subgroup analysis and meta-regression, guidance modality and study size were found to explain the heterogeneity. Of the patients with symptomatic air embolism, 32.7% had unfavorable outcomes. The presence of an underlying disease (odds ratio [OR], 5.939; 95% CI, 1.029-34.279; p = 0.046), the use of a ≥ 19-gauge needle (OR, 10.046; 95% CI, 1.103-91.469; p = 0.041), and coronary or intracranial air embolism (OR, 19.871; 95% CI, 2.725-14.925; p = 0.003) were independent risk factors for symptomatic embolism. Unfavorable outcomes were independently associated with the use of aspiration biopsy rather than core biopsy (OR, 3.302; 95% CI, 1.149-9.492; p = 0.027) and location of the air embolism in the coronary arteries or intracranial spaces (OR = 5.173; 95% CI = 1.309-20.447; p = 0.019).
CONCLUSION
The pooled incidence of symptomatic air embolism after PTLB was 0.08%, and one-third of cases had sequelae or died. Identifying whether coronary or intracranial emboli exist is crucial in suspected cases of air embolism after PTLB.
KEY POINTS
• The pooled incidence of symptomatic air embolism after percutaneous transthoracic lung biopsy was 0.08%, and one-third of patients with symptomatic air embolism had sequelae or died. • The risk factors for symptomatic air embolism were the presence of an underlying disease, the use of a ≥ 19-gauge needle, and coronary or intracranial air embolism. • Sequelae and death in patients with symptomatic air embolism were associated with the use of aspiration biopsy and coronary or intracranial locations of the air embolism.
Topics: Biopsy, Needle; Embolism, Air; Humans; Incidence; Lung; Prognosis; Risk Factors; Tomography, X-Ray Computed
PubMed: 33051730
DOI: 10.1007/s00330-020-07372-w -
Journal of Korean Medical Science Oct 2008Venous air embolism (VAE) is the entrapment of air or medical gases into the venous system causing symptoms and signs of pulmonary vessel obstruction. The incidence of... (Review)
Review
Venous air embolism (VAE) is the entrapment of air or medical gases into the venous system causing symptoms and signs of pulmonary vessel obstruction. The incidence of VAE during cesarean delivery ranges from 10 to 97% depending on surgical position or diagnostic tools, with a potential for life-threatening events. We reviewed extensive literatures regarding VAE in detail and herein described VAE during surgery including cesarean delivery from background and history to treatment and prevention. It is intended that present work will improve the understanding of VAE during surgery.
Topics: Anesthesia, Obstetrical; Cesarean Section; Echocardiography, Transesophageal; Embolism, Air; Female; Humans; Intraoperative Complications; Monitoring, Intraoperative; Obstetrics; Pregnancy; Risk Factors; Ultrasonography, Doppler
PubMed: 18955777
DOI: 10.3346/jkms.2008.23.5.753 -
Proceedings of the National Academy of... Jun 2021An air embolism is induced by intravascular bubbles that block the blood flow in vessels, which causes a high risk of pulmonary hypertension and myocardial and cerebral...
An air embolism is induced by intravascular bubbles that block the blood flow in vessels, which causes a high risk of pulmonary hypertension and myocardial and cerebral infarction. However, it is still unclear how a moving bubble is stopped in the blood flow to form an air embolism in small vessels. In this work, microfluidic experiments, in vivo and in vitro, are performed in small vessels, where bubbles are seen to deform and stop gradually in the flow. A clot is always found to originate at the tail of a moving bubble, which is attributed to the special flow field around the bubble. As the clot grows, it breaks the lubrication film between the bubble and the channel wall; thus, the friction force is increased to stop the bubble. This study illustrates the stopping process of elongated bubbles in small vessels and brings insight into the formation of air embolism.
Topics: Air; Animals; Blood Vessels; Cell Aggregation; Embolism, Air; Friction; Lubrication; Rabbits; Rheology
PubMed: 34155104
DOI: 10.1073/pnas.2025406118 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... May 2019A venous air embolism can occur as a result of circumstances that include blunt head or chest trauma, thoracentesis, arterial catheterization, neurosurgery, cardiac...
A venous air embolism can occur as a result of circumstances that include blunt head or chest trauma, thoracentesis, arterial catheterization, neurosurgery, cardiac surgery, and Caisson disease. The formation of a venous air embolism requires an air source, interaction between the air source and the vessel, and a pressure gradient supporting air migration into the vessel. Air enters through the impaired venous structure and travels to the right side of the heart and the pulmonary arteries, and depending on the amount of air, may occasionally be fatal. This report is the description of the case of a 3-year-old child who developed a fatal venous and cerebral embolism during neurosurgery for the treatment of skull fractures with epidural and subdural bleeding due to blunt head and chest trauma resulting from a television falling on her. The pathophysiology of death and notes regarding the medico-legal autopsy procedure in such cases are discussed. Meticulous autopsy techniques must be used to determine the presence of an air embolism in cases of blunt trauma, especially in patients with blunt trauma to the head who die during neurosurgery, and possible future malpractice claims should be kept in mind.
Topics: Accidents; Child, Preschool; Embolism, Air; Fatal Outcome; Female; Head Injuries, Closed; Humans; Intracranial Embolism; Neurosurgical Procedures
PubMed: 31135947
DOI: 10.5505/tjtes.2018.58201 -
BMC Pulmonary Medicine Jul 2021Endobronchial electrocautery is a common and safe therapeutic endoscopic treatment for malignant airway obstruction. Cerebral arterial air embolism (CAAE) is a rare but... (Review)
Review
BACKGROUND
Endobronchial electrocautery is a common and safe therapeutic endoscopic treatment for malignant airway obstruction. Cerebral arterial air embolism (CAAE) is a rare but potentially fatal complication of endobronchial electrocautery.
CASE PRESENTATION
We present the first case of cerebral arterial air embolism after endobronchial electrocautery. A 56-year-old male with a pulmonary tumour in the right upper lobe received repeated endobronchial electrocautery. During the procedure, he experienced unresponsiveness, hypoxemia and bradycardia, and he developed tetraplegia. Brain computed tomography showed several cerebral arterial air emboli with low-density spots in the right frontal lobe. He received hyperbaric oxygen therapy with almost full recovery, except for residual left-sided weakness.
CONCLUSIONS
General physicians should realize that CAAE may be a possible complication of endobronchial electrocautery. Several measures, including avoiding positive pressure, lowering ventilatory pressures if possible, avoiding advancing the bronchoscope to occlude the bronchus and using the non-contact technique, should be used to prevent this devastating complication.
Topics: Bronchoscopy; Cerebral Arteries; Electrocoagulation; Embolism, Air; Humans; Hyperbaric Oxygenation; Lung Neoplasms; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 34247608
DOI: 10.1186/s12890-021-01580-w -
Tidsskrift For Den Norske Laegeforening... Jan 2019
Topics: Aged; Brachiocephalic Veins; Embolism, Air; Female; Humans; Patient Positioning; Tomography, X-Ray Computed
PubMed: 30644669
DOI: 10.4045/tidsskr.18.0017 -
European Review For Medical and... Dec 2013Pacemaker implantation has developed into a mature technology, meanwhile, implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT), as... (Review)
Review
OBJECTIVES
Pacemaker implantation has developed into a mature technology, meanwhile, implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy (CRT), as extended pace making technology, are both carried out in rising frequency. Massive pulmonary air embolism is a rare but fatal complication accompanying with such pace making process. The objective of this study was to investigate the epidemiology, pathophysiological mechanism, occurrence and treatment for this kind of complication.
PATIENTS AND METHODS
Two cases of complicated massive pulmonary gas embolism were presented: one in CRT and the other in pacemaker implantation, both of which were captured rapidly and treated successfully by inhalation of high flow oxygen, closure of gas inflow tract, position change, and vasoactive drugs. Moreover, published literatures about air embolism in the process of pacemaker implantation or CRT/ICD were summarized and analyzed.
RESULTS
Complicated massive pulmonary air embolisms could be successfully resolved with satisfied short-term prognosis. Literature analysis showed that massive pulmonary air embolism is very rare in the course of pacemaker implantation, and coughing or deep breathing, advanced age, preoperative sedation, sheath with large cavity, improperly operating the hemostasis valve and diminished compliance of pulmonary circulation might be risk factors for air embolism.
CONCLUSIONS
Massive pulmonary air embolism during pace making which is very rare in the course of pacemaker implantation is one kind of life-threatening complication. Rapid judgment and timely treatment can avoid a catastrophic event, which could prevent adverse impact on the short-term prognosis, while further observation is required to explore the long-term prognosis.
Topics: Aged, 80 and over; Cardiac Resynchronization Therapy Devices; Cardiac Surgical Procedures; Embolism, Air; Humans; Male; Pacemaker, Artificial; Pulmonary Embolism; Risk Factors; Time Factors; Treatment Outcome
PubMed: 24338456
DOI: No ID Found -
The New England Journal of Medicine Nov 2018
Topics: Abdominal Pain; Aged; Embolism, Air; Fatal Outcome; Humans; Intestines; Ischemia; Male; Portal Vein; Tomography, X-Ray Computed
PubMed: 30462931
DOI: 10.1056/NEJMicm1806082 -
The Journal of Extra-corporeal... Sep 2011
Topics: Cardiopulmonary Bypass; Embolism, Air; Extracorporeal Circulation; Humans; Microbubbles; Oxygenators
PubMed: 22167841
DOI: No ID Found