Scruggs Jesse E, Joffe Aaron, Wood Kenneth E
Section of Pulmonary/Critical Care Medicine, University of Wisconsin Hospital and Clinics, Madison, Wisconsin 53792, USA.
J Intensive Care Med. 2008 May-Jun;23(3):204-9. doi: 10.1177/0885066607312865.
The use of the central venous catheter may be complicated by air embolism when central venous pressure is subatmospheric and the catheter is open to the surrounding air. Paradoxical air embolus occurs when the gas bubbles are able to traverse a right to left shunt, gaining access to the systemic arterial circulation causing ischemic symptoms in end organs. In this article, a case of a patient with an unknown patent foramen ovale through which air entered the arterial circulation resulting in obtundation and stroke after inadvertent manipulation of a Hickman catheter is presented. The physiology, clinical manifestations, and management strategies are also discussed.
当中心静脉压低于大气压且中心静脉导管向周围空气开放时，使用中心静脉导管可能会并发空气栓塞。当气泡能够穿过右向左分流进入体循环动脉系统，导致终末器官出现缺血症状时，就会发生反常空气栓塞。本文介绍了一例患者，其卵圆孔未闭情况不明，在不经意间操作希克曼导管后，空气通过该孔进入动脉循环，导致患者昏迷和中风。文中还讨论了其生理机制、临床表现及处理策略。
