II. Retrograde cerebral venous gas embolism: are we missing too many cases?

Bothma, Pieter; Schlimp, Christoph J.

doi:10.1093/bja/aet433

Cited by 29 publications

(23 citation statements)

References 17 publications

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“…Once the need for definitive therapy which includes HBOT has been identified, institution of such therapy should be expedited. Some studies indicate that HBOT treatment can still have a beneficial role up to 30 h after the initial event [31,32], but some authors have raised the possibility that not all physicians are enthusiastic about hyperbaric treatment for air embolism, despite several series showing good outcomes if HBOT is commenced at an early stage [33]. …”

Section: Discussionmentioning

confidence: 99%

“…Air embolism is listed as a “never event” by The National Quality Forum, highlighting the importance of instituting effective preventative and management measures [38]. Ultimately, institutional risk-reduction policies should at a minimum be established, and the implementation of standardization, staff training, and targeted requisition of equipment with anti-embolism safety features is crucial [33,39]. …”

Section: Discussionmentioning

confidence: 99%

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Air Embolism: Diagnosis, Clinical Management and Outcomes

et al. 2017

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Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center. Electronic medical records were searched for all cases of air embolism over a 25-year period; relevant medical and imaging records were reviewed. Sixty-seven air embolism cases were identified; the mean age was 59 years (range, 3–89 years). Ninety-four percent occurred in-hospital, of which 77.8% were during an operation/invasive procedure. Vascular access-related procedures (33%) were the most commonly associated with air embolism. Clinical signs and symptoms were related to the location the air embolus; 36 cases to the right heart/pulmonary artery, 21 to the cerebrum, and 10 were attributed to patent foramen ovale (PFO). Twenty-one percent of patients underwent hyperbaric oxygen therapy (HBOT), 7.5% aspiration of the air, and 63% had no sequelae. Mortality rate was 21%; 69% died within 48 hours. Thirteen patients had immediate cardiac arrest where mortality rate was 53.8%, compared to 13.5% (p = 0.0035) in those without. Air emboli were mainly iatrogenic, primarily associated with endovascular procedures. High clinical suspicion and early treatment are critical for survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Air Embolism: Diagnosis, Clinical Management and Outcomes

et al. 2017

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“…Due to a combination of low overall incidence and some cases where the diagnosis goes undiagnosed [2], an anesthesiologist or intensive care specialist may see only a few or none during their career. A common error is for the air embolism to be misdiagnosed as a thrombotic or thrombo-embolic stroke [8]. …”

Section: Etiology Of Air Embolismmentioning

confidence: 99%

Air Embolism: Practical Tips for Prevention and Treatment

McCarthy

Behravesh

Naidu

et al. 2016

JCM

102

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Air embolism is a rarely encountered but much dreaded complication of surgical procedures that can cause serious harm, including death. Cases that involve the use of endovascular techniques have a higher risk of air embolism; therefore, a heightened awareness of this complication is warranted. In particular, central venous catheters and arterial catheters that are often placed and removed in most hospitals by a variety of medical practitioners are at especially high risk for air embolism. With appropriate precautions and techniques it can be preventable. This article reviews the causes of air embolism, clinical management and prevention techniques.

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“…This is the most common scenario in clinical settings ending up with stroke due to arterial embolism in central nervous system. On the other hand, retrograde cerebral venous air embolism is a rare but fatal complication with few cases reported in literature 3, 4…”

Section: Introductionmentioning

confidence: 99%

Pneumocephalus in a patient with multiple stab wounds

Savran

Karaçam

Bayram

et al. 2017

Turkish Journal of Emergency Medicine

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Pneumocephalus is a complication of trauma to the chest and many iatrogenic interventions. It may arise due to systemic air embolism or retrograde cerebral venous air embolism which is an extremely rare complication. We report a 26-years-old female patient who presented to the Emergency Department suffering of multiple stab wounds. She was in a state of shock and after first aid and evaluation she was operated successfully. In the early postoperative period generalized tonic clonic convulsions were observed following cardiopulmonary resuscitation due to sudden cardiovascular collapse. Brain computerized tomography demonstrated free air in intracranial and extracranial venous structures. Pneumocephalus was diagnosed which may be due to a wide spectrum of etiologies including thorax or spinal stab wounds, tube thoracostomy, cardiopulmonary resuscitation or even central venous catheterization. Unfortunately, the patient ended up with brain death despite all effort. In conclusion, we recommend physicians to be aware of this catastrophic complication while taking care of patients with stab wounds.

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II. Retrograde cerebral venous gas embolism: are we missing too many cases?

Cited by 29 publications

References 17 publications

Air Embolism: Diagnosis, Clinical Management and Outcomes

Air Embolism: Diagnosis, Clinical Management and Outcomes

Air Embolism: Practical Tips for Prevention and Treatment

Pneumocephalus in a patient with multiple stab wounds

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