Arterial gas embolism: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Due to negative intrathoracic pressure from spontaneous breathing | |||
*May be fatal when air entry reaches 200-300 mL (pressure gradient of 5 mmHg across 14 ga catheter entrains air at 100 mL/sec) | |||
*Prevention is most important | |||
**Positive pressure mechanical ventilation reduces positive pressure gradient | |||
**Trendelenburg for insertion/removal of IJV and subclav lines | |||
**Reverse Trendelenburg for femoral | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 19:25, 10 February 2015
Background
- Due to negative intrathoracic pressure from spontaneous breathing
- May be fatal when air entry reaches 200-300 mL (pressure gradient of 5 mmHg across 14 ga catheter entrains air at 100 mL/sec)
- Prevention is most important
- Positive pressure mechanical ventilation reduces positive pressure gradient
- Trendelenburg for insertion/removal of IJV and subclav lines
- Reverse Trendelenburg for femoral
Clinical Features
- Acute dyspnea, chest tightness, LOC, cardiac arrest
Differential Diagnosis
Dialysis Complications
- Dialysis-associated hypotension
- Dialysis disequilibrium syndrome
- Air embolism
- Missed dialysis (pulmonary edema)
Workup
Management
Disposition
- Treat w/ 100% NRB