Wong Steve Siu-Man, Kwaan Hau C, Ing Todd S
Department of Medicine, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China.
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Clin Kidney J. 2017 Dec;10(6):797-803. doi: 10.1093/ckj/sfx064. Epub 2017 Jul 28.
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures. The not-that-uncommon occurrence of venous air embolism, often precipitated by improper patient positioning during cervical catheter procedures, suggests that awareness of this procedure-related complication among health care workers is not universal. This review aims to update the pathophysiology of venous air embolism and to emphasize the importance of observing the necessary precautionary measures during central catheter use in hopes of eliminating this unfortunate but easily avoidable mishap in nephrology practice.
静脉空气栓塞是一种可怕的病症，在肾脏病领域尤为相关。在存在有利的气-血压力梯度以及大气与静脉之间存在异常连通的情况下，空气进入循环很常见，并且可导致静脉空气栓塞。这些空气栓子可通过三条主要途径迁移至不同部位：肺循环、反常栓塞以及逆行向上至脑静脉系统。尽管进行了及时且积极的治疗，但这种疾病实体经常出现不良后果，这表明了解潜在病理生理机制以及实施各种预防措施的重要性。静脉空气栓塞并非罕见，常在颈部导管操作期间因患者体位不当而引发，这表明医护人员对这种与操作相关的并发症的认识并不普遍。本综述旨在更新静脉空气栓塞的病理生理学，并强调在使用中心导管期间遵守必要预防措施的重要性，以期消除肾脏病实践中这种不幸但易于避免的意外情况。
