Near-fatal pulmonary air embolus from presumed inadvertent pressure placed on a partially empty plastic intravenous infusion bag

Rothenberg, Florence; Schumacher, John R.; Rosenthal, Robert L.

doi:10.1016/0002-9149(94)90170-8

Cited by 10 publications

(5 citation statements)

References 6 publications

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“…The first reports of VAE related to transfusion equipment were by Simpson in 1942 4,8 . Recent reports highlight the problems that may occur 9–11 . VAE has been described in several other settings, including pulmonary barotrauma 12 , penetrating thoracic trauma 13,14 , obstetrics 15 and neurosurgery 16 .…”

Section: Discussionmentioning

confidence: 99%

Venous air embolism related to the use of a pressure device for rapid blood transfusion

Hore

1996

Emergency Medicine

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A 70 year old woman received a transfusion of packed red blood cells via the distal port of a subclavian central venous catheter. In order to facilitate flow, the blood pack was placed within a manually inflatable pressure bag. When the patient's oxygen saturation and systolic blood pressure fell precipitously, it was noticed that the blood pack was empty and that air was present along the entire length of the intravenous tubing. A provisional diagnosis of venous air embolism was made. Management consisted of positioning the woman head‐down in the left lateral decubitus position and ventilating with 100% oxygen. Air was unable to be aspirated from the affected central venous catheter port. Her condition improved and her subsequent intensive care unit course was uneventful. A pulmonary artery catheter recorded haemodynamic changes at the time of the venous air embolism. There was an initial increase in pulmonary artery pressure and central venous pressure, associated with a decrease in mean arterial pressure and oxygen saturation. Similar observations have been made in animal models of graded (infusion type) venous air embolism. The diagnosis of venous air embolism is generally clinical, aided by echocardiogram, end‐tidal carbon dioxide monitoring, pulse oximetry, chest radiography and haemodynamic monitoring. Current management of venous air embolism includes prevention of further air entry, positioning the patient head‐down in the left lateral decubitus position and administration of 100% oxygen. External cardiac massage, aspiration of air (via central venous catheter, pulmonary artery catheter or transcutaneously) and hyperbaric oxygen may also play a role.

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Section: Discussionmentioning

confidence: 99%

Venous air embolism related to the use of a pressure device for rapid blood transfusion

Hore

1996

Emergency Medicine

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“…Room air entered the open sheath as the patient performed a deep inspiration, creating pressure gradient between the outer environment and the right‐sided chambers. Several therapeutic options may be of help in such a critical situation: air aspiration, mechanical fragmentation of the air embolus, external cardiac massage, putting the patient in a Trendelenburg position, administration of 100% oxygen, or using hyperbaric oxygen therapy 5 …”

Section: Commentmentioning

confidence: 99%

Massive Transient Pulmonary Air Embolism During Pacemaker Implantation Under Mild Sedation:

Turgeman¹,

Antonelli²,

Atar³

et al. 2004

Pacing Clinical Electrophis

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We present a case of a massive pulmonary air embolism during permanent pacemaker lead implantation under mild sedation in a 73-year-old woman. We used a peel-away sheath that is devoid of a hemostatic valve. The air embolism occurred after deep inspiration associated with loud snoring sounds and resolved after short chest massage and administration of adrenaline. Temporary closure of the intravenous entrance route of the peel-away sheath before inserting the lead may prevent this potentially lethal complication.

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“…Air embolism can complicate peripheral IV fluid therapy[1] or central venous catheter monitoring, including problems with IV infusion pumps,[2] improper flushing of IV sets,[3] incorrect injection of drugs into the infusion system,[3] and accidental disconnection of the hub or removal of central venous catheters. [4] The open to air system in glass bottles is also a potential hazard for life-threatening complications.…”

Section: Introductionmentioning

confidence: 99%

U turn to venous air embolism

Singh¹,

Tewari²,

Kaur³

et al. 2009

Indian Journal of Critical Care Medicine

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Near-fatal pulmonary air embolus from presumed inadvertent pressure placed on a partially empty plastic intravenous infusion bag

Cited by 10 publications

References 6 publications

Venous air embolism related to the use of a pressure device for rapid blood transfusion

Venous air embolism related to the use of a pressure device for rapid blood transfusion

Massive Transient Pulmonary Air Embolism During Pacemaker Implantation Under Mild Sedation:

U turn to venous air embolism

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