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高压氧疗法治疗房间隔缺损患者因医源性静脉空气输注导致的血管空气栓塞:一例报告

Hyperbaric Oxygen Therapy for Vascular Air Embolism From Iatrogenic Intravenous Infusion of Air in a Patient With Atrial Septal Defect: A Case Report.

作者信息

Trent Julian S, Hodgson Joni K, Ackermann Bret, Studer Nicholas M

机构信息

Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, USA.

Undersea and Hyperbaric Medicine, San Antonio Uniformed Services Health Education Consortium, San Antonio, USA.

出版信息

Cureus. 2020 Aug 4;12(8):e9554. doi: 10.7759/cureus.9554.

Abstract

Vascular air embolism (VAE) is an important complication of some routine medical procedures, particularly intravenous access for the administration of fluids or medications. The capillary bed of the pulmonary circulatory system is capable of compensating for small amounts of air entrained into a vein. However, large amounts of air can overwhelm that system and lead to complications ranging from cough, chest pain, or shortness of breath to cardiopulmonary collapse. Additionally, air entrained directly into the arterial system, or that which crosses from the venous system to the arterial system through a shunt can cause the acute coronary syndrome, loss of consciousness, arrhythmias, altered mental status, stroke, or limb ischemia. We present a case in which a patient with a known atrial septal defect had a moderate volume of air entrained through an intravenous catheter requiring hyperbaric oxygen therapy.

摘要

血管空气栓塞(VAE)是一些常规医疗程序的重要并发症,尤其是在进行静脉输液或给药时建立静脉通路的过程中。肺循环系统的毛细血管床能够代偿少量进入静脉的空气。然而,大量空气会使该系统不堪重负,导致从咳嗽、胸痛或呼吸急促到心肺功能衰竭等一系列并发症。此外,直接进入动脉系统的空气,或通过分流从静脉系统进入动脉系统的空气,可导致急性冠状动脉综合征、意识丧失、心律失常、精神状态改变、中风或肢体缺血。我们报告一例已知患有房间隔缺损的患者,通过静脉导管进入了适量空气,需要进行高压氧治疗。

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本文引用的文献

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Air embolism: diagnosis and management.空气栓塞:诊断与处理
Future Cardiol. 2017 Jul;13(4):365-378. doi: 10.2217/fca-2017-0015. Epub 2017 Jun 23.
2
Air Embolism: Diagnosis, Clinical Management and Outcomes.空气栓塞:诊断、临床管理与结果
Diagnostics (Basel). 2017 Jan 17;7(1):5. doi: 10.3390/diagnostics7010005.
5
Acute management of vascular air embolism.血管空气栓塞的急性处理
J Emerg Trauma Shock. 2009 Sep;2(3):180-5. doi: 10.4103/0974-2700.55330.
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Paradoxical air embolism successfully treated with hyperbaric oxygen.高压氧成功治疗反常空气栓塞。
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Diagnosis and treatment of vascular air embolism.血管空气栓塞的诊断与治疗。
Anesthesiology. 2007 Jan;106(1):164-77. doi: 10.1097/00000542-200701000-00026.
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Gas embolism: pathophysiology and treatment.
Clin Physiol Funct Imaging. 2003 Sep;23(5):237-46. doi: 10.1046/j.1475-097x.2003.00505.x.

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