Torres Martínez Fernando J, Kuffler Damien P
Department of Hyperbaric Medicine, Puerto Rico Medical Services Administration.
Undersea Hyperb Med. 2011 Jul-Aug;38(4):297-304.
Gas embolism, the entry of gas into vascular structures, can result in serious morbidity and death. It is an inadvertent clinical problem, but it also occurs in non-clinical environments. Gas embolisms result from procedures performed in almost all clinical specialties, thus making it a problem about which all clinicians should be aware. In most cases, gas embolism is air embolism, although it can result from the introduction of gases such as carbon dioxide, nitrous oxide and nitrogen. Gas embolism takes two forms, venous and arterial, distinguished by the mechanism of gas entry and the site where the emboli ultimately lodge. Techniques used to eliminate embolisms including administration of 100% oxygen, placing the patient in lateral decubitus, and Trendelenburg position for no longer than 10 minutes, removing the embolism with a catheter, surfactants and hyperbaric oxygen therapy (HBO2T). For venous gas embolisms surgical removal is recommended, while for arterial embolisms, HBO2T is highly recommended. Here we report on a patient who inadvertently received a venous infusion of 150 ml air resulting in a major embolism, and who underwent HBO2T, recovered well, and suffered no adverse events. This result suggests that it is important to consider HBO2T as a recommended application for patients with venous embolisms.
气体栓塞，即气体进入血管结构，可导致严重的发病和死亡。它是一个意外的临床问题，但也发生在非临床环境中。几乎所有临床专科进行的手术都会导致气体栓塞，因此这是一个所有临床医生都应了解的问题。在大多数情况下，气体栓塞是空气栓塞，尽管它也可能由二氧化碳、一氧化二氮和氮气等气体的引入引起。气体栓塞有两种形式，即静脉型和动脉型，可根据气体进入的机制和栓子最终停留的部位来区分。用于消除栓塞的技术包括给予100%氧气、将患者置于侧卧位和头低脚高位不超过10分钟、用导管清除栓塞、使用表面活性剂和高压氧治疗（HBO2T）。对于静脉气体栓塞，建议手术清除；而对于动脉栓塞，强烈推荐HBO2T。在此，我们报告一例患者，该患者意外静脉输注了150毫升空气，导致严重栓塞，接受了HBO2T治疗，恢复良好，未出现不良事件。这一结果表明，将HBO2T视为静脉栓塞患者的推荐治疗方法很重要。
