Abstract
Accidental air entry during central venous catheterization is a preventable iatrogenic complication that can cause venous air embolism (VAE). Many cases of VAE are subclinical with no adverse outcome and thus go unreported. Usually, when symptoms are present, they are nonspecific, and a high index of clinical suspicion of possible VAE is required to prompt investigations and initiate appropriate therapy. Occasionally large embolism can lead to life-threatening acute cor pulmonale, asystole, sudden death, and arterial air embolism in the presence of shunt or patent foramen ovale. This paper discusses VAE during emergency central line placement and the diagnostic dilemma that it can be created in critically ill patients. All necessary precautions have to be strictly followed to prevent this iatrogenic complication.
Highlights
Venous air embolism (VAE) is a subset of gas embolism which can result in serious morbidity and mortality
We report a case of VAE in a critically ill patient detected incidentally in CT imaging, and the air was found in the hepatic venous system
In a critically ill patient, serious abdominal conditions that can lead to hepatic-portal venous gas have to be excluded before attributing it to iatrogenic complication, and they are summarized in Table 1 [7, 8]
Summary
Venous air embolism (VAE) is a subset of gas embolism which can result in serious morbidity and mortality It is a common iatrogenic complication and most often associated with invasive vascular procedures, hemodialysis, central venous catheterization, high-pressure mechanical ventilation, thoracentesis, and diagnostic radiocontrast injection [1,2,3,4,5]. The major concerns were to exclude serious intra-abdominal pathology, such as bowel wall ischemia, intra-abdominal abscess, and septic thrombophlebitis that might have caused it. When such etiologies are excluded, it is essential to exactly pinpoint the iatrogenic cause, so that it can be prevented in the future. VAE has primary complications resulting from “air lock” in the right ventricular (RV) outflow tract increasing the RV strain and reducing the cardiac output
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
