Pulmonary air embolism

An infrequent complication in the radiology suite

Julio Lanfranco Molina, Ivan Romero Legro, Amado Freire, Katherine Nearing, Sanjay Ratnakant

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Unusual or unexpected effect of treatment Background: Air embolism can occur in a number of medical-surgical situations. Venous air embolism is frequently lethal when a substantial amount enters the venous circulation rapidly and can lead to significant morbidity if crossover to the systemic arterial circulation occurs. The diagnosis of massive air embolism is usually made on clinical grounds by the development of abrupt hemodynamic compromise. The true incidence, morbidity, and mortality of this event is unknown given the difficulties in diagnosis. Case Report: An inadvertent antecubital venous injection of 150 mL of air using a contrast power injector during a computed tomography (CT) is reported. Immediate imaging (CT) showed a significant amount of air in the right atrium and right ventricular cavity, and air mixed with contrast in the main pulmonary artery and proximal divisions of the pulmonary circulation. Patient condition deteriorated requiring mechanical ventilation for 48 hours. Condition improved over the next few days and patient was successfully extubated and discharged home. Conclusions: Air embolism is a rare complication, the potential for this to be life threatening makes prevention and early detection of this condition essential. This condition should be suspected when patients experience sudden onset respiratory distress and/or experience a neurological event in the setting of a known risk factor. Treatment options include Durant’s maneuver; left-lateral decubitus, head-down positioning; to decrease air entry into the right ventricle outflow tract, hyperbaric therapy, 100% O2 and supportive care.

Original languageEnglish (US)
Pages (from-to)80-84
Number of pages5
JournalAmerican Journal of Case Reports
Volume18
DOIs
StatePublished - Jan 24 2017

Fingerprint

Air Embolism
Pulmonary Embolism
Radiology
Air
Tomography
Morbidity
Pulmonary Circulation
Heart Atria
Artificial Respiration
Pulmonary Artery
Heart Ventricles
Therapeutics
Hemodynamics
Head
Injections
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Pulmonary air embolism : An infrequent complication in the radiology suite. / Lanfranco Molina, Julio; Romero Legro, Ivan; Freire, Amado; Nearing, Katherine; Ratnakant, Sanjay.

In: American Journal of Case Reports, Vol. 18, 24.01.2017, p. 80-84.

Research output: Contribution to journalArticle

@article{e12bfc2ea2a14287bec52b241871064e,
title = "Pulmonary air embolism: An infrequent complication in the radiology suite",
abstract = "Objective: Unusual or unexpected effect of treatment Background: Air embolism can occur in a number of medical-surgical situations. Venous air embolism is frequently lethal when a substantial amount enters the venous circulation rapidly and can lead to significant morbidity if crossover to the systemic arterial circulation occurs. The diagnosis of massive air embolism is usually made on clinical grounds by the development of abrupt hemodynamic compromise. The true incidence, morbidity, and mortality of this event is unknown given the difficulties in diagnosis. Case Report: An inadvertent antecubital venous injection of 150 mL of air using a contrast power injector during a computed tomography (CT) is reported. Immediate imaging (CT) showed a significant amount of air in the right atrium and right ventricular cavity, and air mixed with contrast in the main pulmonary artery and proximal divisions of the pulmonary circulation. Patient condition deteriorated requiring mechanical ventilation for 48 hours. Condition improved over the next few days and patient was successfully extubated and discharged home. Conclusions: Air embolism is a rare complication, the potential for this to be life threatening makes prevention and early detection of this condition essential. This condition should be suspected when patients experience sudden onset respiratory distress and/or experience a neurological event in the setting of a known risk factor. Treatment options include Durant’s maneuver; left-lateral decubitus, head-down positioning; to decrease air entry into the right ventricle outflow tract, hyperbaric therapy, 100{\%} O2 and supportive care.",
author = "{Lanfranco Molina}, Julio and {Romero Legro}, Ivan and Amado Freire and Katherine Nearing and Sanjay Ratnakant",
year = "2017",
month = "1",
day = "24",
doi = "10.12659/AJCR.901098",
language = "English (US)",
volume = "18",
pages = "80--84",
journal = "American Journal of Case Reports",
issn = "1941-5923",
publisher = "International Scientific Literature, Inc",

}

TY - JOUR

T1 - Pulmonary air embolism

T2 - An infrequent complication in the radiology suite

AU - Lanfranco Molina, Julio

AU - Romero Legro, Ivan

AU - Freire, Amado

AU - Nearing, Katherine

AU - Ratnakant, Sanjay

PY - 2017/1/24

Y1 - 2017/1/24

N2 - Objective: Unusual or unexpected effect of treatment Background: Air embolism can occur in a number of medical-surgical situations. Venous air embolism is frequently lethal when a substantial amount enters the venous circulation rapidly and can lead to significant morbidity if crossover to the systemic arterial circulation occurs. The diagnosis of massive air embolism is usually made on clinical grounds by the development of abrupt hemodynamic compromise. The true incidence, morbidity, and mortality of this event is unknown given the difficulties in diagnosis. Case Report: An inadvertent antecubital venous injection of 150 mL of air using a contrast power injector during a computed tomography (CT) is reported. Immediate imaging (CT) showed a significant amount of air in the right atrium and right ventricular cavity, and air mixed with contrast in the main pulmonary artery and proximal divisions of the pulmonary circulation. Patient condition deteriorated requiring mechanical ventilation for 48 hours. Condition improved over the next few days and patient was successfully extubated and discharged home. Conclusions: Air embolism is a rare complication, the potential for this to be life threatening makes prevention and early detection of this condition essential. This condition should be suspected when patients experience sudden onset respiratory distress and/or experience a neurological event in the setting of a known risk factor. Treatment options include Durant’s maneuver; left-lateral decubitus, head-down positioning; to decrease air entry into the right ventricle outflow tract, hyperbaric therapy, 100% O2 and supportive care.

AB - Objective: Unusual or unexpected effect of treatment Background: Air embolism can occur in a number of medical-surgical situations. Venous air embolism is frequently lethal when a substantial amount enters the venous circulation rapidly and can lead to significant morbidity if crossover to the systemic arterial circulation occurs. The diagnosis of massive air embolism is usually made on clinical grounds by the development of abrupt hemodynamic compromise. The true incidence, morbidity, and mortality of this event is unknown given the difficulties in diagnosis. Case Report: An inadvertent antecubital venous injection of 150 mL of air using a contrast power injector during a computed tomography (CT) is reported. Immediate imaging (CT) showed a significant amount of air in the right atrium and right ventricular cavity, and air mixed with contrast in the main pulmonary artery and proximal divisions of the pulmonary circulation. Patient condition deteriorated requiring mechanical ventilation for 48 hours. Condition improved over the next few days and patient was successfully extubated and discharged home. Conclusions: Air embolism is a rare complication, the potential for this to be life threatening makes prevention and early detection of this condition essential. This condition should be suspected when patients experience sudden onset respiratory distress and/or experience a neurological event in the setting of a known risk factor. Treatment options include Durant’s maneuver; left-lateral decubitus, head-down positioning; to decrease air entry into the right ventricle outflow tract, hyperbaric therapy, 100% O2 and supportive care.

UR - http://www.scopus.com/inward/record.url?scp=85011674808&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011674808&partnerID=8YFLogxK

U2 - 10.12659/AJCR.901098

DO - 10.12659/AJCR.901098

M3 - Article

VL - 18

SP - 80

EP - 84

JO - American Journal of Case Reports

JF - American Journal of Case Reports

SN - 1941-5923

ER -