Air Embolism: Diagnosis, Clinical Management and Outcomes

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...

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Main Authors: Colin J. McCarthy, Sasan Behravesh, Sailendra G. Naidu, Rahmi Oklu
Format: Article
Language:English
Published: MDPI AG 2017-01-01
Series:Diagnostics
Subjects:
Online Access:http://www.mdpi.com/2075-4418/7/1/5
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author Colin J. McCarthy
Sasan Behravesh
Sailendra G. Naidu
Rahmi Oklu
author_facet Colin J. McCarthy
Sasan Behravesh
Sailendra G. Naidu
Rahmi Oklu
author_sort Colin J. McCarthy
collection DOAJ
description 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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spelling doaj.art-73da7de5bca344e38923497eb9ecf5042022-12-22T03:59:09ZengMDPI AGDiagnostics2075-44182017-01-0171510.3390/diagnostics7010005diagnostics7010005Air Embolism: Diagnosis, Clinical Management and OutcomesColin J. McCarthy0Sasan Behravesh1Sailendra G. Naidu2Rahmi Oklu3Massachusetts General Hospital, Harvard Medical School, Division of Interventional Radiology, 55 Fruit Street, GRB-290A, Boston, MA 02114, USAMayo Clinic, Division of Vascular and Interventional Radiology, 13400 E Shea Blvd, Scottsdale, AZ 85259, USAMayo Clinic, Division of Vascular and Interventional Radiology, 13400 E Shea Blvd, Scottsdale, AZ 85259, USAMayo Clinic, Division of Vascular and Interventional Radiology, 13400 E Shea Blvd, Scottsdale, AZ 85259, USAAir 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.http://www.mdpi.com/2075-4418/7/1/5air embolusangiographyembolization
spellingShingle Colin J. McCarthy
Sasan Behravesh
Sailendra G. Naidu
Rahmi Oklu
Air Embolism: Diagnosis, Clinical Management and Outcomes
Diagnostics
air embolus
angiography
embolization
title Air Embolism: Diagnosis, Clinical Management and Outcomes
title_full Air Embolism: Diagnosis, Clinical Management and Outcomes
title_fullStr Air Embolism: Diagnosis, Clinical Management and Outcomes
title_full_unstemmed Air Embolism: Diagnosis, Clinical Management and Outcomes
title_short Air Embolism: Diagnosis, Clinical Management and Outcomes
title_sort air embolism diagnosis clinical management and outcomes
topic air embolus
angiography
embolization
url http://www.mdpi.com/2075-4418/7/1/5
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AT sasanbehravesh airembolismdiagnosisclinicalmanagementandoutcomes
AT sailendragnaidu airembolismdiagnosisclinicalmanagementandoutcomes
AT rahmioklu airembolismdiagnosisclinicalmanagementandoutcomes