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Air embolism central venous catheter

Elizabeth A Mattox
Most hospitalized patients have placement of a peripheral venous access device, either a short peripheral catheter or a peripherally inserted central catheter. Compared with central venous catheters that are not peripherally inserted, the other 2 types are generally perceived by health care providers as safer and less complicated to manage, and less emphasis is placed on the prevention and management of complications. Expertise of nurses in inserting, managing, and removing these devices may reduce the likelihood of complications, and increased recognition of complications associated with use of the devices is important to ensure continued improvements in the safety, quality, and efficiency of health care...
April 2017: Critical Care Nurse
Frederik Seiler, Franziska Trudzinski, Kai Hennemann, Tom Niermeyer, Christian Schmoll, Annegret Kamp, Robert Bals, Ralf Muellenbach, Hendrik Haake, Philipp M Lepper
Extracorporeal carbon dioxide removal (ECCO2R) is increasingly considered a viable therapeutic approach in the management of hypercapnic lung failure in order to avoid intubation or to allow lung-protective ventilator settings. This study aimed to analyze efficacy and safety of a minimal-invasive ECCO2R device, the Homburg lung. The Homburg lung is a pump-driven system for veno-venous ECCO2R with ¼" tubing and a 0.8 m surface oxygenator. Vascular access is usually established via a 19F/21cm bilumen cannula in the right internal jugular vein...
January 19, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Ahmad Ali Amirghofran, Narjes Nick, Mina Amiri, Rahim Hemmati
The patient was a 32-year-old woman who presented with infertility secondary to uterine didelphys. Hysteroscopic metroplasty was chosen as the corrective surgical procedure for this anatomical defect. During the surgical repair, the patient developed a massive air embolism (MAE) leading to hypotension, arrhythmia, and cardiogenic shock. Resuscitation was started by placing the patient in the right-side up position, and emplacement of central venous catheter, but it was unsuccessful. The decision was then made to bypass the patient's cardiopulmonary system to effectively treat the MAE...
December 2016: Journal of Extra-corporeal Technology
Colin J McCarthy, Sasan Behravesh, Sailendra G Naidu, Rahmi Oklu
Air embolism is a rarely encountered but much dreaded complication of surgical procedures that can cause serious harm, including death. Cases that involve the use of endovascular techniques have a higher risk of air embolism; therefore, a heightened awareness of this complication is warranted. In particular, central venous catheters and arterial catheters that are often placed and removed in most hospitals by a variety of medical practitioners are at especially high risk for air embolism. With appropriate precautions and techniques it can be preventable...
October 31, 2016: Journal of Clinical Medicine
J Abram, J Klocker, N Innerhofer-Pompernigg, M Mittermayr, M C Freund, N Gravenstein, V Wenzel
Injuries to blood vessels near the heart can quickly become life-threatening and include arterial injuries during central venous puncture, which can lead to hemorrhagic shock. We report 6 patients in whom injury to the subclavian artery and vein led to life-threatening complications. Central venous catheters are associated with a multitude of risks, such as venous thrombosis, air embolism, systemic or local infections, paresthesia, hemothorax, pneumothorax, and cervical hematoma, which are not always immediately discernible...
November 2016: Der Anaesthesist
Rashmi Mishra, Pavithra Reddy, Misbahuddin Khaja
Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful...
2016: Case Reports in Critical Care
Frank Born, Nawid Khaladj, Maximilian Pichlmaier, René Schramm, Christian Hagl, Sabina P W Guenther
BACKGROUND: Air embolism is a potentially fatal but underrecognized complication in Extracorporeal Life Support (ECLS). Oxygenators containing venous air traps have been developed to minimize the risk of air embolism in daily care. OBJECTIVE: We reproduced air embolism as occurring via a central venous catheter in an experimental setting to test the potential of oxygenators with and without venous bubble trap (VBT) to withhold air. METHODS: An in vitro ECLS circuit was created and a central venous catheter with a 3-way stopcock and a perforated male luer cap was inserted into the inflow line...
2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
B Balakrishnan, Z Noor, C L Curran
INTRODUCTION: Venous air embolism (VAE) due to central venous catheter (CVC) placement is a rare but preventable complication which is potentially fatal. We describe a case highlighting unique patient characteristics which increase the risk of developing VAE. CASE DESCRIPTION: A sixty-year-old gentleman was admitted to the hospital with dyspnea and altered mental status. His comorbidities include cancer of the neck and tongue, currently in remission, and schizophrenia...
2016: Respiratory Medicine Case Reports
João Pinho, José Manuel Amorim, José Manuel Araújo, Helena Vilaça, Manuel Ribeiro, João Pereira, Carla Ferreira
OBJECTIVE: Cerebral gas embolism (CGE) is a potentially catastrophic complication of central venous catheters (CVCs) manipulation or accidental disconnection, which is rarely reported in the literature. This systematic review aims to characterize the clinical manifestations, imaging features and outcome of CGE associated with CVCs. METHODS: Systematic literature search of all published cases of CGE associated with CVCs, and identification of previously unreported local cases...
March 15, 2016: Journal of the Neurological Sciences
Sun-Key Kim, In-Gu Jun, Dong-Min Jang, Jinwook Lim, Gyu-Sam Hwang, Young-Kug Kim
Cerebral air embolism is a rare but potentially life-threatening complication. We experienced a living-donor liver transplant recipient who presented with unexpected cerebral air embolism and transient neurologic abnormalities that subsequently developed just after the removal of the pulmonary artery catheter from the central venous access device. One day after the initial event, the patient's neurologic status gradually improved. The patient was discharged 30 days after liver transplantation without neurologic sequelae...
February 2016: Korean Journal of Anesthesiology
Umberto G Rossi, Pierluca Torcia, Paolo Rigamonti, Francesca Colombo, Antonino Giordano, Maurizio Gallieni, Maurizio Cariati
Malfunctioning tunneled hemodialysis central venous catheters (CVCs), because of thrombotic or infectious complications, are frequently exchanged. During the CVC exchanging procedure, there are several possible technical complications, as in first insertion, including air embolism. Prevention remains the key to the management of air embolism. Herein, we emphasize the technical tricks capable of reducing the risk of air embolism in long-term CVC exchange. In particular, adoption of a 5 to 10 degrees Trendelenburg position, direct puncture of the previous CVC venous lumen for guide-wire insertion, as opposed to guide-wire introduction after cutting the CVC, a light manual compression of the internal jugular vein venotomy site after catheter removal...
March 2016: Journal of Vascular Access
Jaekyu Ryu, Ji-Hyun Yoon, Eun-Joon Lee, Chia An Lee, Seong Chang Woo, Chang-Young Jeong
Central venous catheters provide long-term available vascular access. They are useful for central venous pressure monitoring, rapid fluid management, massive transfusion and direct cardiovascular medication, especially in operation. Central venous catheterization is usually performed by the landmark bedside technique without imaging guidance. The complications of central venous catheterization are frequent, which include malposition, pneumothorax, hemothorax, chylothorax, arterial puncture, hematoma, air embolism and infection...
August 2015: Korean Journal of Anesthesiology
Chih-Kuang Cheng, Ting-Yu Chang, Chi-Hung Liu, Chien-Hung Chang, Kuo-Lun Huang, Shy-Chyi Chin, Hsiu-Chuan Wu, Yeu-Jhy Chang, Tsong-Hai Lee
BACKGROUND: This study aimed to investigate the clinical predictors of unfavorable prognosis in patients with venous catheter-related cerebral air embolism. METHODS: An extensive review of English literature was performed to obtain reports on cerebral air embolism published between January 1982 and July 2014 through PubMed, Journal at Ovid, and Web of Science using the Mesh terms and keywords "cerebral air embolism" and "cerebral gas embolism." Reports not fulfilling the diagnosis of cerebral air embolism and iterant articles were excluded...
October 2015: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Michelle Feil
The Pennsylvania Patient Safety Reporting System is a confidential, statewide Internet reporting system to which all Pennsylvania hospitals, outpatient-surgery facilities, birthing centers, and abortion facilities must file information on incidents and serious events.Safety Monitor is a column from Pennsylvania's Patient Safety Authority, the authority that informs nurses on issues that can affect patient safety and presents strategies they can easily integrate into practice. For more information on the authority, visit www...
June 2015: American Journal of Nursing
Da Hae Eum, Seung Hwan Lee, Hyung Won Kim, Myung Jae Jung, Jae Gil Lee
Air embolism following central venous catheter (CVC) removal is a relatively uncommon complication. Despite its rare occurrence, an air embolism can lead to serious outcomes. One of the most fatal complications is cerebral air embolism. We report a case of cerebral air embolism that occurred after the removal of a CVC in a patient with an underlying idiopathic pulmonary fibrosis, subcutaneous emphysema, pneumomediastinum, and a possible intrapulmonary shunt. Although the patient had a brief period of recovery, his condition deteriorated again, and retention of carbon dioxide was sustained due to aggravation of pneumonia...
April 2015: Medicine (Baltimore)
Luca Bartolini, Kathleen Burger
No abstract text is available yet for this article.
March 31, 2015: Neurology
Carlo Lomonte, Pasquale Libutti, Francesco Casucci, Piero Lisi, Carlo Basile
The usually applied conversion technique from temporary to tunneled central venous catheters (CVCs) using the same venous insertion site requires a peel-away sheath. We propose a conversion technique without peel-away sheath: a guide wire is advanced through the existing temporary CVC; then, a subcutaneous tunnel is created from the exit to the venotomy site. After removing the temporary CVC, the tunneled one is advanced along the guide wire. The study group included all patients requiring a catheter conversion from January 2012 to June 2014; the control group included incident patients who had received de novo placement of tunneled CVCs from January 2010 to December 2011...
July 2015: Seminars in Dialysis
Ana Tedim, Pedro Amorim, Ana Castro
Venous air embolism (VAE) is the air bubble accumulation in the right side of the heart. Changes in Doppler heart sound (DHS) are characteristic of VAE, and the anesthesiologist has to pay attention to this event continuously, which may not always be possible. This work aims to study different features of the heart sound through a precordial Doppler, that may provide useful information on VAE episodes. A clinical protocol was designed, and DHS was collected at baseline and following infusions of saline with 4 distinct volumes (1ml, 5ml, 8ml and 10ml), and two infusion rates (slow and fast), given by central and peripheric catheters...
2014: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Hisashi Nagai, Hideyuki Maeda, Ryohei Kuroda, Masatomo Komori, Makoto Nakajima, Akina Nara, Takako Ito-Tsujimura, Kaori Shintani-Ishida, Naoki Yahagi, Ken-ichi Yoshida
Pulmonary air embolisms due to the removal of a central venous catheter are rare, but catheter removal is known to be a high risk factor for air embolism. In particular, the removal of a large catheter, such as a double-lumen hemodialysis catheter, can allow a large amount of air to enter into the bloodstream, which often results in sudden death. So, during catheter removal, special care should be taken to prevent air from entering blood vessels, for example, to ensure that the patient's head is tilted downward, that they have inhaled and are holding their breath, and that a covering gauze and inert ointment have been applied to the exit site...
December 2014: American Journal of Forensic Medicine and Pathology
Tarak Rambhatla, Andrew Miller, Bushra Mina
SESSION TITLE: Patient Safety InitiativesSESSION TYPE: Original Investigation SlidePRESENTED ON: Wednesday, October 29, 2014 at 07:30 AM - 08:30 AMPURPOSE: Central venous catheterization (CVC) is performed more than 5 million times a year in the US. The complications of CVC insertion and removal are well known but formal training is typically provided only for CVC insertion and minimal emphasis is placed on CVC removal. Venous air embolism and expanding hematoma are well known complications of improper CVC removal and have been known to cause hypoxemia, airway compression, and death...
October 1, 2014: Chest
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