Lederer Wolfgang, Schlimp Christoph J, Glodny Bernhard, Wiedermann Franz J
Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
BMJ Case Rep. 2011 Jun 30;2011:bcr0420114113. doi: 10.1136/bcr.04.2011.4113.
Air embolism (AE) is a potential complication during transthoracic needle biopsy (TNB). The authors report on venous and systemic AE during CT-guided TNB under general anaesthesia. During the intervention, the radiologist observed accumulation of air bubbles in the left heart chambers, in the right subclavian vein, the superior vena cava and the right atrium. This was presumably due to pressure infusion of contrast medium (CM) air entrained via a stop-cock improperly fixed to the venous cannula or via the injection valve of the cannula by Venturi forces. Prevention of AE related to CM infusion is a subject for institutional risk management. Stop-cocks and injection valves should not be used in intravenous lines supplied by pressure infusions. Adverse outcome may be avoided by placing the patient head down, increasing FiO(2) to 1.0, administering antithrombotic therapy and immobilizing the patient on the intervention table until CT has proved complete remission of AE.
空气栓塞（AE）是经胸针吸活检（TNB）过程中的一种潜在并发症。作者报告了全身麻醉下CT引导TNB期间发生的静脉和全身性AE。在干预过程中，放射科医生观察到左心腔、右锁骨下静脉、上腔静脉和右心房中有气泡积聚。这可能是由于通过未正确固定在静脉套管上的旋塞阀或通过套管的注射阀由文丘里力夹带的造影剂（CM）空气压力注入所致。预防与CM输注相关的AE是机构风险管理的一个课题。在压力输注供应的静脉线路中不应使用旋塞阀和注射阀。将患者头低位、将FiO₂提高到1.0、给予抗血栓治疗并将患者固定在干预台上直至CT证实AE完全缓解，可避免不良后果。
