Air embolism medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Air embolism is a medical emergency and should be treated immediately.
Medical Therapy
The mainstay of therapy for air embolism is high flow oxygen therapy with 100% oxygen.
During surgery:
- Cover surgical site
- This prevents further air trapping[1]
- Tilt operating table
- This lowers the source of air entry and eliminates negative air pressure gradient[2]
- Reverse Trendelenburg in procedures that are lower than the heart[3]
- Jugular venous compression during cranial or facial surgery
- This decreases distal venous pressure and eliminates further air entry from face and head[4]
Post Surgery:
- High flow oxygen therapy/Hyperbaric oxygen therapy
- This increases partial pressure of nitrogen and oxygen in blood leading to decrease in size of bubble and acceleration of bubble resorption[5]
- Aspiration of air from right atrium
- Hemodynamic and Cardiopulmonary resuscitation if necessary
- Some studies have shown cardiac massage may be beneficial
- This forces air out of pulmonary outflow tract leading to improved lateral blood flow[8]
- Some studies have shown cardiac massage may be beneficial
References
- ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). "Diagnosis and treatment of vascular air embolism". Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter
|month=ignored (help) - ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). "Diagnosis and treatment of vascular air embolism". Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter
|month=ignored (help) - ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). "Diagnosis and treatment of vascular air embolism". Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter
|month=ignored (help) - ↑ T. Takahashi, K. Yano, T. Kimura, T. Komatsu & Y. Shimada (1997). "Prevention of venous air embolism by jugular venous compression under superior sagittal sinus pressure monitoring in a brachycephalic patient during craniofacial reconstruction". Paediatric anaesthesia. 7 (3): 259–260. PMID 9189976.
- ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). "Diagnosis and treatment of vascular air embolism". Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter
|month=ignored (help) - ↑ P. S. Colley & A. A. Artru (1989). "Bunegin-Albin catheter improves air retrieval and resuscitation from lethal venous air embolism in upright dogs". Anesthesia and analgesia. 68 (3): 298–301. PMID 2919770. Unknown parameter
|month=ignored (help) - ↑ R. F. Bedford, W. K. Marshall, A. Butler & J. E. Welsh (1981). "Cardiac catheters for diagnosis and treatment of venous air embolism: a prospective study in man". Journal of neurosurgery. 55 (4): 610–614. doi:10.3171/jns.1981.55.4.0610. PMID 6792326. Unknown parameter
|month=ignored (help) - ↑ J. A. ERICSSON, J. D. GOTTLIEB & R. B. SWEET (1964). "CLOSED-CHEST CARDIAC MASSAGE IN THE TREATMENT OF VENOUS AIR EMBOLISM". The New England journal of medicine. 270: 1353–1354. doi:10.1056/NEJM196406182702507. PMID 14140269. Unknown parameter
|month=ignored (help)