Diagnosis and Treatment of Vascular Air Embolism

Abstract

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.

Paradoxical air embolism resulted in acute myocardial infarction and massive ischemic brain injury in a patient operated on in a sitting position

“…По данным ряда авторов [2,14,16,26,27], использова-ние транспищеводной ЭхоКГ во время проведения оперативного вмешательства позволяет быстро об-наружить и исключить возможность появления ве-нозной воздушной эмболии у пациентов из группы риска. Установка транспищеводного датчика и фик-сация его таким образом, чтобы после перевода па-циента в положение сидя на экране монитора были видны верхняя полая вена, правое предсердие и ЛЖ, позволяет вовремя выявить появление микропу-зырьков воздуха в кровеносном русле.…”

Management of Inadvertent Injury to Superior Sagittal Sinus in Parasagittal Meningioma: Technical Note

“…As such, the incidence of VAE remains relatively uncertain and it is usually judged based on symptomatic cases. The sitting position, for instance, carries a risk for VAE ranging between 9.3% and 82.6% [6][7][8][9][10]. The upper end of high risk was reported in posterior fossa surgery performed in the sitting position.…”

Acute stroke due to air embolism complicating ERCP

“…Acute stroke due to air embolism complicating ERCP … Endoscopy 2013; 45: E177-E178 cal symptoms [1,2]. Symptom onset during the position change from prone to supine is characteristic and should trigger immediate suspicion for air embolism.…”