Gas embolism

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
D

deleted171991

I was surprised how easy it is to produce one, especially in certain circumstances. ;)
What about humans? Palmon et al (1997) give a good rundown of these events, and offers a bibliography of case reports. For instance, Allen Yeakel (1968) reports on a lethal venous air embolism of approximately 136ml, which was administered accidentally during an exchange of a plastic blood storage container (the patient was undergoing a carotid endarterectomy). Harrison Martland in 1945 wrote an article describing fatal air emboli in patients who used "powder insufflators" to squirt air into their vaginas for the purpose of antitrichomonal treatment, a technique which is thankfully no longer a part of the gynaecological repertoire because the risk of air embolism is now well-appreciated. That has not stopped people from insufflating each other's vaginas recreationally, with fatal consequences. Judging by the number of case reports this is actually suprisingly commonplace, which somewhat redefines the term "high-risk sexual activity". Less hideous case reports are also available where emboli are the consequence of lung biopsy, bronchogenic cyst rupture, gastrointestinal endoscopy and arthroscopy. Given that it is hard to estimate the volume of air postmortem, Palmon et al conclude that the sudden injection of about 100-300ml of air is enough to cause circulatory arrest.

This is just unbelievable: Fatal Air Embolism in Pregnancy Resulting from an Unusual... : Obstetrics & Gynecology .

Other (i.e. much more frequent) causes:

Venous
  • Automated IV administration devices (perstaltic pump, etc)
  • Disconnected IV access points (eg. loose hubs on the end of a CVC)
  • ECMO circuit disconnection
  • Pulmonary barotrauma from positive pressure ventilation
  • Barotrauma from decompression injury (at altitude or in diving)
  • Venous gas entry during endoscopy or laparoscopy

Arterial
  • Coronary angiography
  • Carotid endarterectomy
  • Ruptured IABP balloon
  • Paradoxical embolism through an intracardiac shunt
  • Paradoxical embolism due to overwhelming volume of pulmonary arterial gas
Mixed (i.e. possibility of both arteral and venous)
  • Intraoperative use of hydrogen peroxide (froth, etc)
  • Cardiothoracic surgery (depending on which chambers are open to air)
  • Decompression
  • Isobaric counterdiffusion (mixed gas diving)

Via: excellent blog article at Deranged Physiology.

Members don't see this ad.
 
There's a company that's been contacting us about trailing some device that detects and shunts air out of the IV lines. Anyone here using it?
Interesting idea, not sure if it has a real use outside of protecting you from gross malpractice or in tiny babies where a little bit of air or bubbles might actually add up to a lot.


--
Il Destriero
 
I was surprised how easy it is to produce one, especially in certain circumstances. ;)


This is just unbelievable: Fatal Air Embolism in Pregnancy Resulting from an Unusual... : Obstetrics & Gynecology .

Other (i.e. much more frequent) causes:

Venous
  • Automated IV administration devices (perstaltic pump, etc)
  • Disconnected IV access points (eg. loose hubs on the end of a CVC)
  • ECMO circuit disconnection
  • Pulmonary barotrauma from positive pressure ventilation
  • Barotrauma from decompression injury (at altitude or in diving)
  • Venous gas entry during endoscopy or laparoscopy

Arterial
  • Coronary angiography
  • Carotid endarterectomy
  • Ruptured IABP balloon
  • Paradoxical embolism through an intracardiac shunt
  • Paradoxical embolism due to overwhelming volume of pulmonary arterial gas
Mixed (i.e. possibility of both arteral and venous)
  • Intraoperative use of hydrogen peroxide (froth, etc)
  • Cardiothoracic surgery (depending on which chambers are open to air)
  • Decompression
  • Isobaric counterdiffusion (mixed gas diving)

Via: excellent blog article at Deranged Physiology.
That ladies, must be why blow jobs are strictly for men.
 
Members don't see this ad :)
We had a massive air embolism this year during a nephrectomy/tumor throbectomy. Got great TEE images of an air locked RVOT.... crashed onto ECMO. Ended up totally neurologically intact which was amazing.


Sent from my iPhone using SDN mobile app
 
  • Like
Reactions: 1 user
We had a massive air embolism this year during a nephrectomy/tumor throbectomy. Got great TEE images of an air locked RVOT.... crashed onto ECMO. Ended up totally neurologically intact which was amazing.


Sent from my iPhone using SDN mobile app


That would be a good case report.
 
  • Like
Reactions: 1 user
Top