Gas Embolism

Daniel Mathieu, Stéphanie Tissier, Marie Boulo

Service d'Urgence Respiratoire, de Réanimation Médicale et de Médecine Hyperbare, Hôpital Calmette, Centre Hospitalier Régional et universitaire, Lille, France

Abstract: Gas embolism (GE) refers to all pathological events related to the entry or the occurrence of gas bubbles in the vascular system. Nowadays, GE is largely an iatrogenic problem that can result in serious morbidity and even death. It can be caused by procedures performed in almost all clinical specialties: heart and neurosurgery, coelioscopy, endoscopy, haemodialysis, central venous catheterization, etc. Upon entering the vascular system, gas bubbles follow the blood stream until they obstruct small vessels. Depending on the access route, gas embolism may be classified as venous or arterial gas embolism. Clinical manifestations depend on the site and extent of vascular obstruction and the subsequent intensity of the systemic inflammatory reactions. Diagnosis is based on the sudden occurrence of neurological and/or cardiac manifestations in clinical situations where there is a risk for GE. Once suspected, treatment for GE must be begun at once, the source identified and eliminated, life support be instituted as required and Hyperbaric Oxygen provided as quickly as possible. All clinicians should be aware of the risks of GE and appropriate preventative measures should be observed whenever there is a risk of occurence

Keywords: gas embolism, arterial gas embolism, venous gas embolism, pulmonary arterial hypertension, blood-gas interface, heart surgery, neurosurgery, coelioscopy, haemodialysis, central venous catheterization

Gas Embolism (GE) refers to all pathological events related to the entry or appearance of bubbles of air or any other gas in the bloodstream.

It is an infrequent accidental pathology, which nowadays is mostly of iatrogenic origin. It may occur during several medical or surgical procedures in which this risk should be realized in order to implement effective preventative strategies. GE is an emergency - outcome depends on the expediency with which hyperbaric oxygen (HBO) is provided.

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