title: Systemic arterial air embolism: positive pressure ventilation can be fatal in a patient with blunt trauma.
abstract: Systemic air embolism is a potentially fatal condition. Although venous embolism is commonly reported after deep sea diving or neurosurgical procedures, arterial embolism is rare. It usually occurs because of lung trauma after biopsy or lung resection but can rarely affect patients of blunt or penetrating trauma to chest managed on positive pressure ventilation. We report a case of road traffic accident with head injury, with normal primary survey of chest and abdomen who developed fatal systemic arterial air embolism immediately after intubation. Postmortem CT scan revealed huge amounts of air in left side of the heart, ascending aorta, arch of aorta, bilateral internal carotids and all right-sided intracranial arteries. In emergency departments of non-specialised centres, such complications are universally fatal. Thus, extreme caution needs to be exercised while managing patients of blunt trauma on mechanical ventilation even if the chest and abdominal examinations are normal.
authors: Department of Surgery, VMMC & Safdarjung Hospital, New Delhi, India.
authors: Siddharth
authors: S
authors: Yadav
authors: Shalabh
authors: S
authors: Jain
authors: Puneet
authors: P
authors: Aggarwal
authors: Ritu
authors: R
authors: Gupta
mesh_terms: D004618:Embolism, Air / Q000000981:diagnostic imaging / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D013898:Thoracic Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult