Fatal Air Embolism During Renal Dialysis

Riddick, LeRoy; Brogdon, B. G.

doi:10.1097/paf.0b013e3181fe7850

Cited by 10 publications

(6 citation statements)

References 6 publications

(4 reference statements)

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“…Owing to safeguards in the modern HD machine, symptomatic air embolism is exceedingly rare during HD. Air may enter the extracorporeal HD circuit either as a result of residual air trapped in the tubing or dialyzer due to incomplete priming or because of a broken or loose luer connection prepump (where the arterial pressure is negative) (25,(28)(29)(30) (Figure 1). Air entering the extracorporeal circuit presents to the venous air trap placed distal to the dialyzer, immediately decreasing the blood level in the chamber.…”

Section: Air Embolismmentioning

confidence: 99%

Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies

Saha

Allon

2016

CJASN

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Given the high comorbidity in patients on hemodialysis and the complexity of the dialysis treatment, it is remarkable how rarely a life-threatening complication occurs during dialysis. The low rate of dialysis emergencies can be attributed to numerous safety features in modern dialysis machines; meticulous treatment and testing of the dialysate solution to prevent exposure to trace elements, toxins, and pathogens; adherence to detailed treatment protocols; and extensive training of dialysis staff to handle medical emergencies. Most hemodialysis emergencies can be attributed to human error. A smaller number are due to rare idiosyncratic reactions. In this review, we highlight major emergencies that may occur during hemodialysis treatments, describe their pathogenesis, offer measures to minimize them, and provide specific interventions to prevent catastrophic consequences on the rare occasions when such emergencies arise. These emergencies include dialysis disequilibrium syndrome, venous air embolism, hemolysis, venous needle dislodgement, vascular access hemorrhage, major allergic reactions to the dialyzer or treatment medications, and disruption or contamination of the dialysis water system. Finally, we describe root cause analysis after a dialysis emergency has occurred to prevent a future recurrence.

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Section: Air Embolismmentioning

confidence: 99%

Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies

Saha

Allon

2016

CJASN

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“…Eighteen ( n = 18) original articles were included 7–24 (Supplemental Appendix 2), pertaining to a total patient pool of 19 patients ( n = 19, 58% male) with a mean age of 54 years (range 27–81). Mechanisms of air introduction were either from central venous access ( n = 15) or peripheral venous access ( n = 4).…”

Section: Discussionmentioning

confidence: 99%

An unusual case of neurocardiogenic syncope: A case report and systematic review

Tan

Adler

Rochow

et al. 2023

Journal of the Royal College of Physicians of Edinburgh

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We present a case of syncopal episode in emergency department (ED) and subsequent admission to the geriatric assessment unit. The patient presented with self-limiting central abdominal pain. Given a history of previous aortic aneurysm repair, a contrast CT angiogram was performed. With no evidence of leaking aneurysm, the patient was discharged from the ED. The syncopal episode happened while waiting for a taxi. A review of the earlier CT scan showed the presence of air in the venous circulatory system. In hindsight, it was thought the syncopal episode occurred due to air embolism introduced during or shortly after venous cannulation. We discuss the aetiology of venous air embolism and highlight the lack of evidence regarding tolerable amounts of air in the circulatory system. Physiological changes associated with age may suggest that elderly patients are uniquely maladapted to overcome sudden insults to their cardiovascular status.

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“…CT scan revealed acute infarction with multiple blisters on the side of the catheter insertion. Ridick and Brogdon reported air embolism during kidney dialysis, which is rare because of the protective mechanisms present in the unit.…”

Section: Discussionmentioning

confidence: 99%

Self‐Induced Fatal Air Embolism: Accidental Autoerotic Death or Suicide?

Modelli

Rodrigues

Castro

et al. 2013

Journal of Forensic Sciences

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Autoeroticism comprises behavior deviations aimed at producing sexual gratification through the manipulation of one's own body. The use of asphyxia and the induction of pain (masochism) are well-known examples. "Atypical forms" of such behaviors have appeared in the literature as isolated cases. Fatal air embolism is most common in women (causing abortion), being very rare in men (urethral trauma). The authors present a probable case of air embolism associated with signs of autoeroticism, instrumented by the delivery of air through a system formed by a compressor (typical of those used in refrigerators), a syringe barrel, a segment of latex tubing (tourniquet), and a needle, which was found inserted into the glans penis of an adult male. The hypothesis of accidental death was chosen due to the findings at the scene. The body was decomposing when found, which hampered the conduction of examinations.

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Fatal Air Embolism During Renal Dialysis

Cited by 10 publications

References 6 publications

Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies

Diagnosis, Treatment, and Prevention of Hemodialysis Emergencies

An unusual case of neurocardiogenic syncope: A case report and systematic review

Self‐Induced Fatal Air Embolism: Accidental Autoerotic Death or Suicide?

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