Complications of Equine Anesthesia
Michele Barletta, Jane Quandt, Rachel Reed in Equine Anesthesia and Pain Management, 2023
Other signs of air embolism include: Collapse/seizure.Anxiety.Malaise.Tachycardia.Tachypnea.Muscle fasciculations.Agitation with abnormal behavior including kicking and flank biting.Cyanosis.
Complications of Percutaneous Lithotripsy
Kevin R. Loughlin in Complications of Urologic Surgery and Practice, 2007
Incremental injections of 5 to 7 cc of air into the renal collecting system via a ureteral catheter can help delineate the posterior calyces for precise nephrostomy access. Although the normal collecting system has a capacity of approximately 10 cc, air embolism secondary to positive pressure air pyelograms have been reported both before and after initial attempts at calyceal access (57,58). Signs suggesting air embolism include oxygen desaturation, decreased end-tidal carbon dioxide, hypotension, and bradycardia. When air embolism is suspected the procedure should be halted and any routes for further air entry should be sealed. The patient should be placed supine in trendelenburg position and if possible with the right side up. Cardiopulmonary resuscitation should be initiated. A right internal jugular central line may confirm diagnosis with aspiration of foamy blood and be used to evacuate air from the right atrium.
Venous air embolism
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Manual of Neuroanesthesia, 2017
Air embolism cannot be confirmed or excluded with any clinical or laboratory finding, hence application of multiple monitoring techniques is recommended.3 If the sensitive monitors to be used cannot provide data continuously, then there should be parameters to describe the relationship between the clinical signs or symptoms and air embolism. In a study conducted by Spektor et al.,3 the authors defined these parameters to calculate the probability of the event to be related with VAE. They described that if there is a sustained (1) decrease in etCO2 by >5 mmHg, (2) increase in heart rate >15%, and (3) decrease in systolic blood pressure >20% for ≥5 min, then it should be accepted to indicate a high probability. And if parameters (1) and (2) sustain for ≥5 min, it should be accepted to indicate a possibility for VAE.
Prime the Line! A Case Report of Air Embolism from a Peripheral IV Line in the Field
Published in Prehospital Emergency Care, 2020
Tiffany M. Abramson, Stephen Sanko, Saman Kashani, Marc Eckstein
Venous air embolisms (VAE) occur when a non-collapsed vein is exposed to the atmosphere and a pressure gradient favors air entry into the vascular system. While most commonly associated with surgical procedures, venous air embolism may also be introduced during vascular access procedures or infusions through peripheral intravenous catheters. Symptoms result from the obstruction of the circulatory system by the air embolism and vary depending on the size of the air embolism (1). Venous air embolisms may be asymptomatic, cause mild respiratory distress and chest pain, or result in cardiovascular collapse (2). The true incidence is unknown and is likely underestimated as VAEs are often subclinical and difficult to detect (3). There are relatively few reports of venous air embolisms secondary to peripheral intravenous access and no reports from the prehospital setting (1, 3, 4).
Percutaneous thermal ablation of hepatocellular carcinomas located in the hepatic dome using artificial carbon dioxide pneumothorax: retrospective evaluation of safety and efficacy
Published in International Journal of Hyperthermia, 2018
Margaux Hermida, Christophe Cassinotto, Lauranne Piron, Eric Assenat, Georges-Philippe Pageaux, Laure Escal, Marie-Ange Pierredon-Foulongne, Daniel Verzilli, Samir Jaber, Boris Guiu
In a study by Fujiwara et al. [23], artificial pneumothorax was performed in 16 patients for thermal ablation of HCCs located in the hepatic dome. They showed the good safety profile of this technique but here again, they used an epidural needle to access the pleural cavity, and air to create the pneumothorax. There is a potential risk of air embolism with the use of air for pleural insufflation [24]. Moreover, air must be removed at the end of the procedure. Interestingly, CO2 is highly soluble (20 times greater than oxygen) in the blood. It can be safely injected in the pleural cavity [25] and does not necessarily need to be aspirated at the end of the procedure. Artificial pneumothorax using CO2 insufflation has already been used for thermal protection of extrathoracic organs during radiofrequency ablation [26,27], for biopsy of the adrenal gland with lung interposition [25], or for pain relief during RFA of peripheral lung tumors [28]. This technique is safe, even in the context of low tidal volume ventilation used to limit liver movements. Indeed, oxygen saturation has never been affected in our 28 patients who had low tidal-volume ventilation during general anaesthesia. To note that expired CO2 monitoring can be influenced by the solubilization of intrapleural CO2 in the blood then evacuated by the respiratory system.
Radiologic mimics of pulmonary embolism
Published in Postgraduate Medicine, 2021
Yuri Matusov, Victor F Tapson
Air embolism has been reported following neurosurgical procedures, cardiac surgery, orthopedic procedures, insertion of subclavian or central venous catheters, transthoracic procedures, barotrauma due to positive pressure ventilation, and gas bubble formation during rapid ascent in scuba diving [68–75]. Mortality in this setting is related closely to the volume of air administered (around 300 ml), speed of delivery (around 100 ml/sec), and proximity of the delivered air to the right heart [76,77], although many patients are asymptomatic [60]. These filling defects have a low density of ≤120 Hounsfield units [78].
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