Life-threatening air embolism during ERCP

Air embolisms are rare life-threatening complications that develop under various conditions, including surgery. During segmentectomy for thoracic surgery, air is blown into the selected bronchus for segment margin detection. This may result in the formation of an air embolus. Herein, we report a case of successful recovery from sudden intraoperative cardiac arrest due to an air embolism in a patient undergoing left superior division segmentectomy via open thoracotomy. Intraoperatively, the patient was positioned head-down. Upon blowing air into the bronchus, the patient suddenly developed cardiac arrest. Open-chest cardiac massage and low-temperature therapy were commenced and the patient recovered. The head-down position prevents the air embolus from reaching the brain and thus prevents severe brain damage, whereas continuous open-chest massage and low temperature prevents severe body damage from anticipated cardiac air embolism. Thus, operation in the head-down position is useful in preventing severe brain damage from brain air embolisms.

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Iatrogenic Hepatic Pneumovenogram

Critical Care Research and Practice ◽

10.1155/2011/731758 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4

Author(s):

Govarthanan Rajendiran ◽

Sulaiman Rathore ◽

Gurmeet Sidhu ◽

James Catevenis

Keyword(s):

Air Embolism ◽

Central Line ◽

Cor Pulmonale ◽

Diagnostic Dilemma ◽

Venous Air Embolism ◽

Iatrogenic Complication ◽

Line Placement ◽

Venous Catheterization ◽

Life Threatening ◽

Appropriate Therapy

Accidental air entry during central venous catheterization is a preventable iatrogenic complication that can cause venous air embolism (VAE). Many cases of VAE are subclinical with no adverse outcome and thus go unreported. Usually, when symptoms are present, they are nonspecific, and a high index of clinical suspicion of possible VAE is required to prompt investigations and initiate appropriate therapy. Occasionally large embolism can lead to life-threatening acute cor pulmonale, asystole, sudden death, and arterial air embolism in the presence of shunt or patent foramen ovale. This paper discusses VAE during emergency central line placement and the diagnostic dilemma that it can be created in critically ill patients. All necessary precautions have to be strictly followed to prevent this iatrogenic complication.

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Case report of venous air embolism in complete placenta previa in a case of lower segment caesarean section

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211541 ◽

2021 ◽

Vol 10 (5) ◽

pp. 2067

Author(s):

Korichi Noureddine ◽

Lakshmi Ramanathan ◽

Aboobaker Thode ◽

Vipin Reghunatan ◽

Vijyakumari .

Keyword(s):

Pulmonary Embolism ◽

Caesarean Section ◽

Amniotic Fluid ◽

Placenta Previa ◽

Fatal Outcome ◽

Air Embolism ◽

Lower Segment ◽

Venous Air Embolism ◽

Lower Segment Caesarean Section ◽

Life Threatening

Thromboembolic episodes in the pregnant and postpartum period in patients remain rare but fatal causes of maternal morbidity and mortality. They can be either venous air embolism, venous thrombo-embolism which include deep vein thrombosis and pulmonary embolism and last but not the least amniotic fluid embolism. The incidence of embolic episodes is more in LSCS patients than in patients coming for normal vaginal deliveries for all the type of embolisms, ranging from 10-97% for air embolisms depending on the surgical position and diagnostic tools with a potential for life threatening events, for venous thromboembolism (VTE) it is 0.5-2.2% patients per 1000 deliveries and increased 5-10-fold in pregnancy and 15-35% in postpartum period as compared to the non-pregnant women, the highest being during the 1st 3-6 weeks postpartum. After that the risk declines rapidly, although a small risk increase persists up to 12 weeks. After delivery, incidence of pulmonary embolism ranges from 0.11-0.73% per 1000 deliveries. It is rare, unpredictable, and unpreventable life-threatening complication of pregnancy. According to the International Cooperative Pulmonary Embolism registry, the death rate from massive PE among hemodynamically unstable patients is 52%. Last but not the least, incidence of amniotic fluid embolism ranges from 1/8000 to 1/15000. Delayed diagnosis, delayed treatment or inadequate treatment and inadequate thromboprophylaxis account for many of these deaths. Hence, early detection and proper management helps to prevent maternal mortality and morbidity in our patients. Also, thrombotic prophylaxis helps in preventing the fatal outcome and morbidity and mortality in our patients. Here, we report a case of a patient with complete placenta Previa scheduled for elective Lower segment caesarean section who developed venous air embolism (VAE) but with prompt detection and treatment a fatal outcome was prevented.

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Diagnosis and Treatment of Vascular Air Embolism

Anesthesiology ◽

10.1097/00000542-200701000-00026 ◽

2007 ◽

Vol 106 (1) ◽

pp. 164-177 ◽

Cited By ~ 320

Author(s):

Marek A. Mirski ◽

Abhijit Vijay Lele ◽

Lunei Fitzsimmons ◽

Thomas J. K. Toung ◽

David C. Warltier

Keyword(s):

Treatment Strategies ◽

Air Embolism ◽

Invasive Procedure ◽

Neurosurgical Procedures ◽

Radiology Suite ◽

Clinical Scenarios ◽

Life Threatening ◽

Interventional Radiology Suite ◽

Monitoring Devices ◽

Life Threatening Event

Vascular air embolism is a potentially life-threatening event that is now encountered routinely in the operating room and other patient care areas. The circumstances under which physicians and nurses may encounter air embolism are no longer limited to neurosurgical procedures conducted in the "sitting position" and occur in such diverse areas as the interventional radiology suite or laparoscopic surgical center. Advances in monitoring devices coupled with an understanding of the pathophysiology of vascular air embolism will enable the physician to successfully manage these potentially challenging clinical scenarios. A comprehensive review of the etiology and diagnosis of vascular air embolism, including approaches to prevention and management based on experimental and clinical data, is presented. This compendium of information will permit the healthcare professional to rapidly assess the relative risk of vascular air embolism and implement monitoring and treatment strategies appropriate for the planned invasive procedure.

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Arterial Air Embolism: A Rare but Life-Threatening Complication of Percutaneous Needle Biopsy of the Lung

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2008.08.035 ◽

2009 ◽

Vol 87 (5) ◽

pp. 1622 ◽

Cited By ~ 8

Author(s):

Yoshinori Ishikawa ◽

Haruhisa Matsuguma ◽

Rie Nakahara ◽

Akiko Ui ◽

Haruko Suzuki ◽

...

Keyword(s):

Needle Biopsy ◽

Air Embolism ◽

Percutaneous Needle Biopsy ◽

Life Threatening ◽

Life Threatening Complication

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Embolic disease

Obstetric Anaesthesia ◽

10.1093/med/9780199688524.003.0020 ◽

2020 ◽

pp. 521-534

Author(s):

Abrie Theron

Keyword(s):

Risk Factors ◽

Clinical Features ◽

Treatment Options ◽

Air Embolism ◽

Pulmonary Angiography ◽

Pulmonary Embolectomy ◽

Anticoagulation Treatment ◽

Life Threatening ◽

Essential Knowledge ◽

Supportive Management

Venous thromboembolism is the leading direct cause of maternal death. Therefore an understanding of the risk factors, clinical presentation, appropriate investigations (i.e. echocardiogram, V/Q Scan, or CT pulmonary angiography) and the treatment options available for managing patients with suspected and confirmed pulmonary embolism (PE) are essential knowledge on an obstetric unit. The chapter includes information on anticoagulation treatment options and the management of life-threatening PE, when thrombolysis or pulmonary embolectomy may be indicated. Amniotic fluid embolism is discussed, reviewing aetiology, pathophysiology, clinical features, diagnosis, and supportive management. Finally air embolism is discussed, also looking at aetiology, pathophysiology, clinical features, diagnosis, and management, emphasizing, however, that prevention is key.

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Life-Threatening Complication of Percutaneous Transthoracic Fine-Needle Aspiration Biopsy: Systemic Arterial Air Embolism

Eurasian Journal of Medicine ◽

10.5152/eajm.2014.51 ◽

2015 ◽

Vol 47 (1) ◽

pp. 72-74 ◽

Cited By ~ 3

Author(s):

Deniz Cebi Olgun ◽

Cesur Samanci ◽

Ayse Seda Ergin ◽

Canan Akman

Keyword(s):

Fine Needle Aspiration ◽

Fine Needle Aspiration Biopsy ◽

Air Embolism ◽

Needle Aspiration ◽

Aspiration Biopsy ◽

Fine Needle ◽

Life Threatening ◽

Life Threatening Complication ◽

Needle Aspiration Biopsy

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Treating ARDS-associated air embolism: a question of priorities

Undersea and Hyperbaric Medicine ◽

10.22462/03.04.2021.7 ◽

2021 ◽

Vol 03 (01) ◽

pp. 169-172

Author(s):

Christopher Nilès ◽

Daniel Mathieu ◽

Erika Parmentier-Decrucq ◽

Keyword(s):

Patient Management ◽

Distress Syndrome ◽

Air Embolism ◽

Clinical Situation ◽

Central Venous Catheters ◽

Central Catheter ◽

Gas Embolism ◽

Central Venous ◽

Life Threatening ◽

Life Threatening Complication

Gas embolism is a potential and often life-threatening complication of central venous catheters. We report a case of air embolism after tearing of the central catheter associated with severe acute respiratory distress syndrome. The severity of the clinical situation meant choices had to be made regarding the order of treatments. This clinical case provided useful eye-openers for patient management regarding the prioritization of treatments as well as the possibilities offered by hyperbaric oxygen therapy.

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