1.Massive Paradoxical Air Embolism in Brain Occurring after Central Venous Catheterization: A Case Report.
Seon Sook HAN ; Sam Soo KIM ; Hyun Pyo HONG ; Seo Young LEE ; Seung Joon LEE ; Bong Ki LEE
Journal of Korean Medical Science 2010;25(10):1536-1538
Cerebral air embolism is a rare but fatal complication of central venous catheterization. Here, we report a case of paradoxical cerebral air embolism associated with central venous catheterization. An 85-yr-old man underwent right internal jugular vein catheterization, and became obtunded. Brain MR imaging and CT revealed acute infarction with multiple air bubbles on the side of catheter insertion. The possibility of cerebral air embolism should be considered in patients developing neurological impairment after central venous catheterization, and efforts should be made to limit cerebral damage.
Aged, 80 and over
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Brain/pathology
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Catheterization, Central Venous/*adverse effects
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Echocardiography, Transesophageal
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Embolism, Air/*etiology/ultrasonography
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Embolism, Paradoxical/*etiology/ultrasonography
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Humans
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Intracranial Embolism/*etiology/ultrasonography
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Magnetic Resonance Imaging
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Male
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Tomography, X-Ray Computed
2.Incidence of Venous Air Embolism during Myomectomy: The Effect of Patient Position.
Jiwon AN ; Seo Kyung SHIN ; Ja Young KWON ; Ki Jun KIM
Yonsei Medical Journal 2013;54(1):209-214
PURPOSE: Venous air embolism (VAE) is characterized by the entrainment of air or exogenous gases from broken venous vasculature into the central venous system. No study exists regarding the effect of patient positioning on the incidence of VAE during abdominal myomectomy. The purpose of this study was to assess the incidence and grade of VAE during abdominal myomectomy in the supine position in comparison to those in the head-up tilt position using transesophageal echocardiography. MATERIALS AND METHODS: In this study, 84 female patients of American Society of Anesthesiologist physical status I or II who were scheduled for myomectomy under general anesthesia were included. Patients were randomly divided into two groups: supine group and head-up tilt group. Transesophageal echocardiography images were videotaped throughout the surgery. The tapes were then reviewed for VAE grading. RESULTS: In the supine group, 10% of the patients showed no VAE. Moreover, 10% of the patients were classified as grade I VAE, while 50% were categorized as grade II, 22.5% as grade III, and 7.5% as grade IV. In the head-up tilt group, no VAE was detected in 43.2% of the patients. In addition, 18.2% of the patients were classified as grade I VAE, 31.8% as grade II, and 6.8% as grade III; no patients showed grade IV. VAE grade in the head-up tilt group was significantly lower than that in the supine group (p<0.001). CONCLUSION: The incidence and grade of VAE in the head-up tilt group were significantly lower than those in the supine group during abdominal myomectomy.
Abdomen/pathology
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Adult
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Echocardiography, Transesophageal
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Embolism, Air/epidemiology/*etiology
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Female
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Humans
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Incidence
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Middle Aged
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Myoma/pathology/*surgery
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*Posture
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Supine Position
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Uterine Myomectomy/adverse effects/*methods
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Uterus/pathology/ultrasonography
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Veins/*ultrasonography