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You are here: Home / 09. Medical/Surgical / Air Embolism

Air Embolism

July 14, 2011 by CrashMaster

Air Embolism

(Review in Anesthesiology 1999;90(2):564)

if patient decompensates just after being placed on mech vent, consider this dx

 

 

caused by gradient of low pressure pulmonary venous system (hypovolemia) and/or increased airway pressure (PPV, cough, tension pneumo)

 

2 cc of air injected into the cerebral circ can be fatal

1 cc of air in the pulm vein can cause cardiac arrest

 

injuries close to the hilium yield the highest risk b/c the pulm vein (low pressure) is close to the large airways

 

Probe positive PFO can allow conduit from venous air embolism

 

paradoxical embolism can also occur in ARDS, pulm htn,

ability of lungs to function as filter is exceeded at 0.35 cc of air per kg per minute

 

blast injury can cause massive air embolism

 

hemoptysis with circulatory and CNS dysfunction is sufficient for provisional diagnosis

 

fundoscopic exam may reveal air in retinal vessels

 

TEE can detect extremely small bubbles

 

tympanic membrane should rupture if lung ruptures in blast injury

 

spont vent is preferred, lung isolation if only one lung injured and ppv is necessary

 

thoracotmy with hilar clamping has been used

 

hyperbarics for SAE

 

HFOV is preferred mode if there is bronchopleural fistula

 

 

 

 

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Filed Under: 09. Medical/Surgical, pulmonology


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