Air embolism

Dutka, A.J., Kochanek, P.M. and Hallenbeck, J.M. (1989). Influence of granulocytopenia on canine cerebral ischemia induced by air embolism. Stroke 20, 390-395. 

Mechanical complications of PN are related to catheter placement and the system and equipment used to administer PN. A central venous catheter must be placed by a trained professional, and risks associated with placement include pneumothorax, arterial puncture, bleeding, hematoma formation, venous thrombosis, and air embolism.1,20 Over time, the catheter may require replacement. Problems with the equipment include malfunctions of the infusion pump, intravenous tubing sets, and filters. 

Possibility that embolic phenomena may occur (either air embolism or vascular clot) as a result of damage to the vascular wall. 

Hemofiltration is similar to hemoperfusion but where the blood enters a filter pumped by anteri-ovenous pressure difference. There is a lack of controlled clinical investigations to study the efficacy of all these techniques and there are inherent risks to these procedures, including hypotension, bleeding, air embolism and metabolic imbalance. 

Both decompression sickness and air embolism can be treated by placing the victim in a hyperbaric chamber. Hyper ... 

TIA, stroke or death as a result of dislodgement of atheromatous plaque by the catheter tip dissection of the arterial wall thrombus formation on the catheter tip air embolism... 

Contraindications. Any closed, distendable air-filled space expands dm-ing administration of nitrous oxide, which moves into it from the blood. It is therefore contraindicated in patients with demonstrable collections of air in the pleural, pericardial or peritoneal spaces intestinal obstruction arterial air embolism decompression sickness severe chronic obstructive airway disease emphysema. Nitrous oxide will cause pressure changes in closed, noncompliant spaces such as the middle ear, nasal sinuses, and the eye. 

Hirst, A.E., Saunders, F.C. Fatal air embolism following perforation of the cecum in a patient with peritoneovenous shunt for ascites. Amer. 

More expensive and costly to produce Potential for infection at site of injection Potential for sepsis Potential for thrombophlebitis Potential for fluid overload Potential for air embolism Potential for extravasation Psychological distress by the patient Require specialized equipment, devices, and techniques to prepare and administer drugs Potential for pain upon injection Potential for tissue damage upon injection Risk of needlestick injuries and exposure to blood-borne pathogens by health care worker Increased morbidity associated with long-term vascular access devices Disposal of needles, syringes, and other infusion devices requires special consideration... 

The risks of exchange transfusion are essentially the same as those described above for massive transfusions, and their magnitude depends on the health of the newborn infant and its gestational age and weight. The transfused blood should be as fresh as possible and should not have been stored for more than 4-5 days. It must be free from antigens that react with antibodies in the maternal plasma. Technical errors involving perforation of the umbilical vein, wrong placement of the cannula, or air embolism are fortunately only rare complications. 

Central venous catheters are reluctantly used as blood access for hemodialysis because of safety concerns and frequent complications, for example sepsis, thrombosis, and vessel stenosis. Nevertheless, 20% or more of all patients rely on atrial catheters for chronic dialysis because of lack of other access. Potentially fatal risks related to central venous catheters include air embolism (1), severe blood loss (2), and electric shock (3). These specific risks have been substantially eliminated by the inherent design and implantation of Dialock (Biolink Corporation, USA). Dialock is a subcutaneous device consisting of a titanium housing with two passages with integrated valves connected to two silicone catheters. The system is implanted subcutaneously below the clavicle. The tips of the catheters are placed in the right atrium. The port is accessed percutaneously with needle cannulas. 

Lung transplant patients appear to be at increased risk of air embolism from catheters perhaps because of the considerable negative intrathoracic pressure that can develop when the diseased lung is replaced with a normal lung. Lung transplant patients are often also emaciated and have little subcutaneous tissue, allowing for a short tract from the central venous line insertion site to the opening of the central vein. 

A 53-year-old woman developed a serious air embolism from the central venous catheter tract after lung transplantation, at the time of removal of the catheter (14). 

The authors referred in their report to four other cases of air embolism in lung transplant patients. 

Orebaugh SL. Venous air embolism clinical and experimental considerations. Crit Care Med 1992 20(8) 1169-77. 

McCarthy PM, Wang N, Birchfield F, Mehta AC. Air embolism in single-lung transplant patients after central venous catheter removal. Chest 1995 107(4) 1178-9. 

The poor solubility of nitrous oxide may be dangerous for patients with pneumothorax, pneumoperitoneum, ileus, or air embolism. 

Three risks of a parenteral nutrition support therapy are pneumothorax, air embolism, and infection. 

Air embolism may occur because of air sucked in via the intravenous line. 

Air embolism is not synonymous with nor a manifestation of decompression sickness. It refers specifically to air embolization of cerebral vessels subsequent to the rupture of lung parenchyma by expanding gases. Air embolism should not be confused with the bubble formation that occurs in the circulatory system and tissues in decompression sickness vide infra). 

Air embolism Introduction of air into the catheter, which subsequently enters the venous circulation... 

Complications resulting from these problems are rare nowadays. They include hyper- and hyponatremia, hyper- and hypokalemia, hypercalcemia, hypermagnesemia, air embolism, overheated dialysate resulting in hemolysis and possibly fatal hyperkalemia, and electrocution (B22). 

With intravenous administration, there is always a risk of damage to veins through mechanical or chemical means. A good cannulation technique is essential to avoid extravasation, tissue damage or the introduction of air into the circulation. Air embolism is a rare but life-threatening complication. Techniques that puncmre the skin can introduce infection through poor aseptic technique or contaminated equipment. Antihistamines and corticosteroids, if needed for adverse reactions, should never be mixed in the same syringe because precipitation would occur. 

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