Gas embolism: an exceptional complication of radial arterial catheterization

Abstract

Misuse of an arterial catheter can lead to a severe gas embolism. The infusion system used to flush arterial catheters should be checked regularly to ensure it contains no gas.

A review of patient safety incidents reported as ‘severe’ or ‘death’ from critical care units in England and Wales between 2004 and 2014

“…There were 22 incidents associated with arterial lines, and incidents associated with hypoglycaemia and air embolus have previously been described in detail . There were 13 cases of ischaemia leading to loss of limbs or digits, four with radial lines, seven with brachial lines and two with femoral lines.…”

A Case Report of Cerebral Air Embolism after Esophagogastroduodenoscopy: Diagnosis and Management in the Emergency Department

“…In the ED, CAE mainly presents in two distinct settings: 1) in the diving environment secondary to rapid ascent, causing nitrogen bubble formation or pulmonary barotrauma, leading to air emboli; 2) in the clinical setting, due to diagnostic or invasive interventions, causing iatrogenic air emboli introduction. Table 1 lists case reports of CAE with a variety of etiologies that could potentially present in the ED (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Paradoxical Air Embolism Successfully Treated With Hyperbaric Oxygen

“…6 In a review of all patients in the literature with cerebral air embolism associated with CVCs from 1975 to 1988, 54% occurred secondary to disconnection of CVCs, 31% occurred during removal of CVCs, and 15% occurred during insertion. 9 Other reported causes of cerebral air embolism include cardiopulmonary bypass, 10 intrathoracic anticancer drug administration, 11 endoscopic retrograde cholangiopancreatography, 12,13 contrast-enhanced computed tomography (CT), 14 CT-guided lung biopsy, 15 compressed air diving, 16 intra-aortic balloon pump rupture, 17 radial artery catheterization, 18,19 cardiopulmonary resuscitation, 20 tracheal extubation, 21 upper endoscopy, 22 endoscopic variceal ligation, 23 inadvertent aircraft depressurization, 24 diagnostic bronchoscopy, 25 transbronchial biopsy, 26,27 lung contusion, 28 inactive tuberculosis cavity, 29 esophageal carcinoma, 30 inhalation of pressurized helium, 31 pleurodesis, 32 cardiac ablation procedures, 33 and cerebral angiography. 34 Symptoms of venous air embolism (VAE) are referable to its effects on gas exchange and central hemodynamics.…”