Rajendiran Govarthanan, Rathore Sulaiman, Sidhu Gurmeet, Catevenis James
Department of Critical Care Medicine, Prince George's Hospital Center, 3001 Hospital Drive, 5th Floor, Cheverly, MD, 20785, USA.
Crit Care Res Pract. 2011;2011:731758. doi: 10.1155/2011/731758. Epub 2011 May 18.
Accidental air entry during central venous catheterization is a preventable iatrogenic complication that can cause venous air embolism (VAE). Many cases of VAE are subclinical with no adverse outcome and thus go unreported. Usually, when symptoms are present, they are nonspecific, and a high index of clinical suspicion of possible VAE is required to prompt investigations and initiate appropriate therapy. Occasionally large embolism can lead to life-threatening acute cor pulmonale, asystole, sudden death, and arterial air embolism in the presence of shunt or patent foramen ovale. This paper discusses VAE during emergency central line placement and the diagnostic dilemma that it can be created in critically ill patients. All necessary precautions have to be strictly followed to prevent this iatrogenic complication.
中心静脉置管期间意外空气进入是一种可预防的医源性并发症，可导致静脉空气栓塞（VAE）。许多VAE病例为亚临床型，无不良后果，因此未被报告。通常，出现症状时，症状是非特异性的，需要高度临床怀疑可能发生VAE，以促使进行检查并启动适当治疗。偶尔，大的栓塞可导致危及生命的急性肺心病、心搏骤停、猝死以及在存在分流或卵圆孔未闭时发生动脉空气栓塞。本文讨论了紧急中心静脉置管期间的VAE以及它可能给重症患者带来的诊断困境。必须严格遵守所有必要的预防措施，以防止这种医源性并发症。
