Paradoxical venous air embolism detected with point-of-care ultrasound: a case report
Abstract Venous air embolism (VAE) is an uncommon event consistent in the entrainment of air from any communication between the environment and the venous vasculature that could occur during central venous catheter (CVC) manipulation, and might trigger circulatory shock within minutes depending on t...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-05-01
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| Series: | The Ultrasound Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13089-022-00265-7 |
| _version_ | 1811338866444992512 |
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| author | Hector Andres Ruiz Avila Hans Fred García-Araque Estivalis Acosta-Gutiérrez |
| author_facet | Hector Andres Ruiz Avila Hans Fred García-Araque Estivalis Acosta-Gutiérrez |
| author_sort | Hector Andres Ruiz Avila |
| collection | DOAJ |
| description | Abstract Venous air embolism (VAE) is an uncommon event consistent in the entrainment of air from any communication between the environment and the venous vasculature that could occur during central venous catheter (CVC) manipulation, and might trigger circulatory shock within minutes depending on the amount of air embolized. We present a case of a critical care patient who presented sudden clinical hemodynamic deterioration after the removal of central venous catheter. Hemodynamic evaluation with point-of-care ultrasound (POCUS) showed bubbles in both right and left heart cavities wherewith air embolism facilitated by heart septal defect was suspected. Therefore, the patient was reintubated, supported with vasopressors and a new CVC was inserted to proceed with air aspiration. Shortly after, the patient’s hemodynamic status improved in terms of vital signs stabilization. 6 h after the event with optimal perfusion markers and diminished sedation, the patient showed left hemiparesis therefore a cerebral magnetic resonance (MRI) was also performed showing hyperintensity in the right precentral gyrus, so ischemic stroke without hemorrhagic transformation diagnosis was made, because of paradoxical embolism. This case report demonstrates the value of POCUS application as a diagnostic tool in the hemodynamically unstable patient. |
| first_indexed | 2024-04-13T18:17:56Z |
| format | Article |
| id | doaj.art-4f6f24bc39494ea88c6abb52e5f4fa5c |
| institution | Directory Open Access Journal |
| issn | 2524-8987 |
| language | English |
| last_indexed | 2024-04-13T18:17:56Z |
| publishDate | 2022-05-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Ultrasound Journal |
| spelling | doaj.art-4f6f24bc39494ea88c6abb52e5f4fa5c2022-12-22T02:35:37ZengSpringerOpenThe Ultrasound Journal2524-89872022-05-011411410.1186/s13089-022-00265-7Paradoxical venous air embolism detected with point-of-care ultrasound: a case reportHector Andres Ruiz Avila0Hans Fred García-Araque1Estivalis Acosta-Gutiérrez2Cuidado Crítico, Hospital Universitario Nacional de ColombiaUniversidad Militar Nueva GranadaCuidado Crítico, Hospital Universitario Nacional de ColombiaAbstract Venous air embolism (VAE) is an uncommon event consistent in the entrainment of air from any communication between the environment and the venous vasculature that could occur during central venous catheter (CVC) manipulation, and might trigger circulatory shock within minutes depending on the amount of air embolized. We present a case of a critical care patient who presented sudden clinical hemodynamic deterioration after the removal of central venous catheter. Hemodynamic evaluation with point-of-care ultrasound (POCUS) showed bubbles in both right and left heart cavities wherewith air embolism facilitated by heart septal defect was suspected. Therefore, the patient was reintubated, supported with vasopressors and a new CVC was inserted to proceed with air aspiration. Shortly after, the patient’s hemodynamic status improved in terms of vital signs stabilization. 6 h after the event with optimal perfusion markers and diminished sedation, the patient showed left hemiparesis therefore a cerebral magnetic resonance (MRI) was also performed showing hyperintensity in the right precentral gyrus, so ischemic stroke without hemorrhagic transformation diagnosis was made, because of paradoxical embolism. This case report demonstrates the value of POCUS application as a diagnostic tool in the hemodynamically unstable patient.https://doi.org/10.1186/s13089-022-00265-7Case reportAir embolismPoint-of-care ultrasoundStroke |
| spellingShingle | Hector Andres Ruiz Avila Hans Fred García-Araque Estivalis Acosta-Gutiérrez Paradoxical venous air embolism detected with point-of-care ultrasound: a case report The Ultrasound Journal Case report Air embolism Point-of-care ultrasound Stroke |
| title | Paradoxical venous air embolism detected with point-of-care ultrasound: a case report |
| title_full | Paradoxical venous air embolism detected with point-of-care ultrasound: a case report |
| title_fullStr | Paradoxical venous air embolism detected with point-of-care ultrasound: a case report |
| title_full_unstemmed | Paradoxical venous air embolism detected with point-of-care ultrasound: a case report |
| title_short | Paradoxical venous air embolism detected with point-of-care ultrasound: a case report |
| title_sort | paradoxical venous air embolism detected with point of care ultrasound a case report |
| topic | Case report Air embolism Point-of-care ultrasound Stroke |
| url | https://doi.org/10.1186/s13089-022-00265-7 |
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