Schlimp Christoph J, Loimer Thomas, Schmidts Michael B, Rieger Michael, Lederer Wolfgang
Trauma Hospital of Klagenfurt, Department of Anaesthesiology and Critical Care Medicine, Waidmannsdorferstr. 35, Klagenfurt, 9021, Austria.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.04.2009.1786. Epub 2009 Jun 26.
An 25-year-old man was buried by an avalanche during off-slope skiing. He was rescued by his companions and resuscitated by mouth-to-mouth ventilation. The emergency physician from a helicopter based emergency medical service placed two venous lines in both external jugular veins and secured the airway with a tracheal tube. When transferred to the emergency department an additional central venous catheter was inserted via his right femoral vein. The subsequent computed tomography scan revealed several small air bubbles adjacent to the endothelium of the brachiocephalic vein. In an experimental setting, it was shown that air could enter the circulation via a central venous catheter within a few seconds, but measured values of embolising air were smaller than the calculated values when applying the law of Hagen-Poiseuille. Nevertheless, it is important to keep the lumens of a central venous catheter filled with saline before any manipulation in order to prevent or attenuate venous air embolism.
一名25岁男性在非斜坡滑雪时被雪崩掩埋。他被同伴救出，并通过口对口通气进行了复苏。来自直升机紧急医疗服务的急诊医生在双侧颈外静脉放置了两条静脉通路，并通过气管导管确保气道安全。当转至急诊科时，又经右股静脉插入了一根中心静脉导管。随后的计算机断层扫描显示，头臂静脉内皮附近有几个小气泡。在实验环境中，研究表明空气可在几秒钟内通过中心静脉导管进入循环，但应用哈根-泊肃叶定律时，栓塞空气的测量值小于计算值。尽管如此，在进行任何操作之前，保持中心静脉导管管腔充满生理盐水以预防或减轻静脉空气栓塞仍然很重要。
