title: Venous and arterial air embolism: a rare phenomenon with fatal consequences.
abstract: Air embolism is often an iatrogenic complication which may occur in venous or arterial circulation depending on the port of entry. We present two cases in which air embolism occurred in venous and arterial circulation after contrast medium injection (CMI) and coronary artery bypass graft (CABG) surgery, respectively. In one case, accumulation of air bubbles was observed in the pulmonary artery after CMI. This was attributed to inadvertent injection of air owing to improper connection of the injector and the catheter. The patient was managed with 100% oxygen in the Trendelenburg and left lateral decubitus position. Repeat imaging demonstrated resorption of the emboli. In another case, air was introduced during CABG in the left atrium and ventricle. Immediate suction of air was attempted however, the patient developed cardiogenic shock requiring vasopressors, and subsequently seizures and coma due to diffuse ischaemic stroke. The patient eventually expired.
authors.affiliation: Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut, USA.
authors.forename: Jatan
authors.initials: J
authors.lastname: Shah
authors.affiliation: Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut, USA.
authors.forename: Nasheena
authors.initials: N
authors.lastname: Jiwa
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts, USA.
authors.forename: Natasha
authors.initials: N
authors.lastname: Mamdani
authors.affiliation: Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut, USA.
authors.forename: David
authors.initials: D
authors.lastname: Hill
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004618:Embolism, Air / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects*; D008297:Male; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D005938:Glucocorticoids