[Cerebral air embolism after central venous catheter].
Introduction of air into the arterial circulation can cause cerebral air embolism, leading to severe neurological deficits. A case is reported on a patient suffering from fatal cerebral air embolism after a subclavian vein catheter had been inserted. The risks associated with inserting and removing central venous catheters are described. Apart from the pathogenesis of a paradoxical air embolism in a patient with a right-to-left shunt due to a patent foramen ovale, air embolism can occur if a large amount of air traverses the pulmonary circulation. The ability of the pulmonary vasculature to filter air may be exceeded by a bolus injection of more than 30 ml air. Air embolism is suspected if acute neurological symptoms occur after inserting a central venous catheter. Echocardiography, especially transoesophageal echocardiography. Is highly sensitive in detecting air emboli in the ventricles. Treatment is effected with hyperbaric oxygen and standard measures of intensive-care medicine.
Schlotterbeck
K
K
Abteilung Kardiologie und Internistische Intensivtherapie, Kreiskrankenhaus Traunstein.
Tanzer
H
H
Alber
G
G
Müller
P
P
D000368:Aged; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002408:Catheters, Indwelling; D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D011859:Radiography; D012307:Risk Factors; D013350:Subclavian Vein