title: Paradoxical air embolism successfully treated with hyperbaric oxygen.
abstract: The use of the central venous catheter may be complicated by air embolism when central venous pressure is subatmospheric and the catheter is open to the surrounding air. Paradoxical air embolus occurs when the gas bubbles are able to traverse a right to left shunt, gaining access to the systemic arterial circulation causing ischemic symptoms in end organs. In this article, a case of a patient with an unknown patent foramen ovale through which air entered the arterial circulation resulting in obtundation and stroke after inadvertent manipulation of a Hickman catheter is presented. The physiology, clinical manifestations, and management strategies are also discussed.
authors.affiliation: Section of Pulmonary/Critical Care Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792, USA.
authors.forename: Jesse E
authors.initials: JE
authors.lastname: Scruggs
authors.forename: Aaron
authors.initials: A
authors.lastname: Joffe
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Wood
mesh_terms: D002405:Catheterization, Central Venous / Q000009:adverse effects; D004618:Embolism, Air / Q000209:etiology / Q000628:therapy*; D054092:Foramen Ovale, Patent / Q000150:complications; D006801:Humans; D006931:Hyperbaric Oxygenation; D008297:Male; D008875:Middle Aged