Eum Da Hae, Lee Seung Hwan, Kim Hyung Won, Jung Myung Jae, Lee Jae Gil
From the Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Medicine (Baltimore). 2015 Apr;94(13):e630. doi: 10.1097/MD.0000000000000630.
Air embolism following central venous catheter (CVC) removal is a relatively uncommon complication. Despite its rare occurrence, an air embolism can lead to serious outcomes. One of the most fatal complications is cerebral air embolism. We report a case of cerebral air embolism that occurred after the removal of a CVC in a patient with an underlying idiopathic pulmonary fibrosis, subcutaneous emphysema, pneumomediastinum, and a possible intrapulmonary shunt. Although the patient had a brief period of recovery, his condition deteriorated again, and retention of carbon dioxide was sustained due to aggravation of pneumonia. Despite full coverage of antibiotics and maximum care with the ventilator, the patient died about 5 weeks after the removal of the CVC. We suggest that strict compliance to protocols is required even while removing the catheter. Furthermore, additional caution to avoid air embolism is demanded in high-risk patients, such as in this case.
中心静脉导管（CVC）拔除后发生空气栓塞是一种相对罕见的并发症。尽管其发生率很低，但空气栓塞可导致严重后果。最致命的并发症之一是脑空气栓塞。我们报告一例脑空气栓塞病例，该病例发生在一名患有特发性肺纤维化、皮下气肿、纵隔气肿以及可能存在肺内分流的患者拔除CVC之后。尽管患者有一段短暂的恢复时期，但其病情再次恶化，并且由于肺炎加重导致二氧化碳潴留持续存在。尽管使用了足量抗生素并对呼吸机进行了最大程度的护理，但患者在拔除CVC约5周后死亡。我们建议即使在拔除导管时也需要严格遵守操作规程。此外，对于高危患者，如本病例中的患者，需要格外小心以避免空气栓塞。
