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Case Reports
. 2018 Jul 8:2018:5808390.
doi: 10.1155/2018/5808390. eCollection 2018.

Uncommon Occurrences of Air Embolism: Description of Cases and Review of the Literature

Giorgio Berlot  1 , Adriano Rinaldi  1 , Marco Moscheni  1 , Massimo Ferluga  1 , Perla Rossini  1
Affiliations
Case Reports

Uncommon Occurrences of Air Embolism: Description of Cases and Review of the Literature

Giorgio Berlot et al. Case Rep Crit Care. .

Abstract

Many different risk factors have been associated with the occurrence of gas embolism making this potentially lethal complication easily avoidable. However, this condition can occur in circumstances not commonly reported. Three different and extremely uncommon cases of gas embolism are presented and discussed: the first was caused by the voluntary ingestion of hydrogen peroxide, the second occurred during a retrograde cholangiopancreatography, and the last followed the intrapleural injection of Urokinase. Whereas in the first patient the gas embolism was associated with only relatively mild digestive symptoms, in the remaining two it caused a massive cerebral ischemia and an extended myocardial infarction, respectively. Despite a hyperbaric oxygen therapy performed timely in each case, only the first patient survived. The classical risk factors associated with gas embolism like indwelling central venous catheters, diving accidents, etc. are rather well known and thus somewhat preventable; however, a number of less common and difficult-to-recognize causes can determine this condition, making the correct diagnosis elusive and delaying the hyperbaric oxygen therapy, whose window of opportunity is rather narrow. Thus, a gas embolism should be suspected in the presence of not otherwise explainable sudden neurologic and/or cardiovascular symptoms also in circumstances not typically considered at risk.

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Figures

Figure 1
Figure 1
US Navy decompression Table 6.
Figure 2
Figure 2
Abdominal CT scan: (a) GE in the peripheral branch of the portal system after HP ingestion; (b) reduction of the GE after HBOT.
Figure 3
Figure 3
Head CT scan: (a) before HBOT: gas bubbles in the basal nuclei and (b) within the subarachnoid spaces (arrows); (c) immediately after HBOT: single right frontal bubble (circle) and 4 mm: leftward deviation of the midline (arrow); (d) 14 hours after HBOT 4 mm: leftward deviation of the midline; (e) 5 days after right decompressive craniectomy: massive brain herniation with right hemispheric and left frontal ischemia.
Figure 4
Figure 4
(a): Air within the cortical vessels (arrows); (b) air within the ascending and thoracic descending aorta (arrows); (c) air within the coronary arteries (circle); (d) air within the aortic arch and the left ventricle.
Figure 5
Figure 5
(a) Acute myocardial infarction involving extensively the right ventricle and the septum; (b) acute cerebral infarction downstream the arteries obstructed by the GE.
Figure 6
Figure 6
Routes of dissemination of GE.
See this image and copyright information in PMC

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References

    1. McCarthy C., Behravesh S., Naidu S., Oklu R. Air Embolism: Practical Tips for Prevention and Treatment. Journal of Clinical Medicine. 2016;5(11):p. 93. doi: 10.3390/jcm5110093. - DOI - PMC - PubMed
    1. Mirski M. A., Lele A. V., Fitzsimmons L., Toung T. J. K. Diagnosis and treatment of vascular air embolism. Anesthesiology. 2007;106(1):164–177. doi: 10.1097/00000542-200701000-00026. - DOI - PubMed
    1. Gordy S., Rowell S. Vascular air embolism. International Journal of Critical Illness & Injury Science. 2013;3(1):73–76. doi: 10.4103/2229-5151.109428. - DOI - PMC - PubMed
    1. Goldfarb B., Bahnson H. T. Early and late effects on the heart of small amounts of air in the coronary circulation. The Journal of Thoracic and Cardiovascular Surgery. 1963;46:368–378. - PubMed
    1. Michel L., Poskanzer D. C., McKusick K. A., Nardi G. L., Malt R. A. Fatal Paradoxical Air Embolism to the Brain: Complication of Central Venous Catherization. Journal of Parenteral and Enteral Nutrition. 1982;6(1):68–70. doi: 10.1177/014860718200600168. - DOI - PubMed

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