Pulmonary gas embolism
Updates to Article Attributes
Pulmonary air emboli are a specific type of pulmonary emboli.
Clinical presenationpresentation
CanPresentation can vary dependant on the degree of air emboli where patients with small amount of air can be asymptomatic. Commonly reported clinical manifestations include sudden dyspnoea, chest pain, hypotension and/or convulsions 4.
Pathology
CausesAetiology
They can arise from both iatrogenic and non-iatrogenic causes.
Iatrogenic causes
Venous air embolism is a well-known complication of thoracic trauma, surgery, and a variety of diagnostic and therapeutic procedures. Small quantities of air has been reported in the central veins in up to 23% of patients during contrast material administration for CT scans3.
Non iatrogenic causes
Non-iatrogenic air emboliembolism can sometimes occurs in SCUBA divers as a result of gas bubble formation in the blood, which occurs due to rapid reduction in the ambient pressure during a diver's ascent.
Radiographic features
Plain film - chest radiograph
Chest radiographs are usually normal unless there is a massive load of emboli. In the event of a large volume of air emboli, there may be areas of hyperlucency overlying the heart shadow, main pulmonary artery, or hepatic veins. Features of focal pulmonary oligemia, pulmonary oedema, or enlargement of the central pulmonary arteries or superior vena cava may be seen.
CT
May show some of the above plain film features in detail as well as allow direct visualisation of air in the systemic veins, right sided cardiac chambers or main pulmonary arteries.
Treatment and prognosis
The risk of death is affected by both the amount of air and the speed of introduction; the minimum lethal volume and injection rate in humans are thought to be around 300-500 mL and 100 mL/sec, respectively 4.
Complications
- pulmonary oedema due to air embolism
- cardiovascular dysfunction and failure: can occur from
obstructionobstruction of the right ventricular pulmonary outflow tract or obstruction of the pulmonary arterioles by a mixture of air bubbles and fibrin clots formed in the heart 3 - cerebral air embolism: which in turn may result in cerebral oedema or ischaemic stroke
See also
-<p><strong>Pulmonary air emboli</strong> are a specific type of <a href="/articles/pulmonary-emboli">pulmonary emboli</a>. </p><h4>Clinical presenation</h4><p>Can vary dependant on the degree of air emboli where patients with small amount of air can be asymptomatic. Commonly reported clinical manifestations include sudden dyspnoea, chest pain, hypotension and/or convulsions <sup>4</sup>.</p><h4>Pathology</h4><h5>Causes</h5><p>They can arise from both iatrogenic and non-iatrogenic causes. </p><h6>Iatrogenic causes</h6><p>Venous air embolism is a well-known complication of thoracic trauma, surgery, and a variety of diagnostic and therapeutic procedures. Small quantities of air has been reported in the central veins in up to 23% of patients during contrast material administration for CT scans <sup>3</sup>. </p><h6>Non iatrogenic causes</h6><p>Non-iatrogenic air emboli can sometimes occurs in SCUBA divers as a result of gas bubble formation in the blood, which occurs due to rapid reduction in the ambient pressure during a diver's ascent.</p><h4>Radiographic features</h4><h5>Plain film - chest radiograph</h5><p>Chest radiographs are usually normal unless there is a massive load of emboli. In the event of a large volume of air emboli, there may be areas of hyperlucency overlying the heart shadow, main <a href="/articles/pulmonary-artery">pulmonary artery</a>, or <a href="/articles/hepatic-veins">hepatic veins</a>. Features of focal pulmonary oligemia, <a href="/articles/pulmonary-oedema">pulmonary oedema</a>, or enlargement of the central pulmonary arteries or <a href="/articles/superior-vena-cava">superior vena cava</a> may be seen. </p><h5>CT</h5><p>May show some of the above plain film features in detail as well as allow direct visualisation of air in the systemic veins, right sided cardiac chambers or main pulmonary arteries.</p><h4>Treatment and prognosis</h4><p>The risk of death is affected by both the amount of air and the speed of introduction; the minimum lethal volume and injection rate in humans are thought to be around 300-500 mL and 100 mL/sec, respectively <sup>4</sup>. </p><h5>Complications</h5><ul>- +<p><strong>Pulmonary air emboli</strong> are a specific type of <a href="/articles/pulmonary-emboli">pulmonary emboli</a>. </p><h4>Clinical presentation</h4><p>Presentation can vary dependant on the degree of air emboli where patients with small amount of air can be asymptomatic. Commonly reported clinical manifestations include sudden dyspnoea, chest pain, hypotension and/or convulsions <sup>4</sup>.</p><h4>Pathology</h4><h5>Aetiology</h5><p>They can arise from both iatrogenic and non-iatrogenic causes. </p><h6>Iatrogenic causes</h6><p>Venous air embolism is a well-known complication of thoracic trauma, surgery, and a variety of diagnostic and therapeutic procedures. Small quantities of air has been reported in the central veins in up to 23% of patients during contrast material administration for CT scans <sup>3</sup>. </p><h6>Non iatrogenic causes</h6><p>Non-iatrogenic air embolism can sometimes occurs in SCUBA divers as a result of gas bubble formation in the blood, which occurs due to rapid reduction in the ambient pressure during a diver's ascent.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Chest radiographs are usually normal unless there is a massive load of emboli. In the event of a large volume of air emboli, there may be areas of hyperlucency overlying the heart shadow, main <a href="/articles/pulmonary-artery">pulmonary artery</a>, or <a href="/articles/hepatic-veins">hepatic veins</a>. Features of focal pulmonary oligemia, <a href="/articles/pulmonary-oedema">pulmonary oedema</a>, or enlargement of the central pulmonary arteries or <a href="/articles/superior-vena-cava">superior vena cava</a> may be seen. </p><h5>CT</h5><p>May show some of the above plain film features in detail as well as allow direct visualisation of air in the systemic veins, right sided cardiac chambers or main pulmonary arteries.</p><h4>Treatment and prognosis</h4><p>The risk of death is affected by both the amount of air and the speed of introduction; the minimum lethal volume and injection rate in humans are thought to be around 300-500 mL and 100 mL/sec, respectively <sup>4</sup>. </p><h5>Complications</h5><ul>
-<li>cardiovascular dysfunction and failure: can occur from obstruction of the right ventricular pulmonary outflow tract or obstruction of the pulmonary arterioles by a mixture of air bubbles and fibrin clots formed in the heart <sup>3</sup>- +<li>cardiovascular dysfunction and failure: can occur from obstruction of the right ventricular pulmonary outflow tract or obstruction of the pulmonary arterioles by a mixture of air bubbles and fibrin clots formed in the heart <sup>3</sup>
-<a title="cerebral air embolism" href="/articles/cerebral-air-embolism">cerebral air embolism</a>: which in turn may result in cerebral oedema or ischaemic stroke</li>-</ul><h4>See also</h4><ul><li><a href="/articles/cerebral-air-embolism">cerebral air embolism</a></li></ul><p> </p>- +<a href="/articles/cerebral-air-embolism">cerebral air embolism</a>: which in turn may result in cerebral oedema or ischaemic stroke</li>
- +</ul><h4>See also</h4><ul><li><a href="/articles/cerebral-air-embolism">cerebral air embolism</a></li></ul>
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