Amiot Félix, Ramakers Michel, Fleury Dan, Malherbe Jolan
Department of Emergency Medicine, SAMU 50, Centre Hospitalier Mémorial France Etats-Unis, Saint-Lô, France.
Service de réanimation, Centre Hospitalier Mémorial France Etats-Unis, Saint-Lô, France.
J Am Coll Emerg Physicians Open. 2025 Jun 16;6(4):100201. doi: 10.1016/j.acepjo.2025.100201. eCollection 2025 Aug.
Venous air embolism (VAE) is a rare but potentially life-threatening complication of intraosseous access. We report the case of a 57-year-old woman who presented to the emergency department following deliberate self-poisoning and subsequently developed VAE associated with intraosseous access. Transthoracic echocardiography revealed acute cor pulmonale with air bullae migrating from the inferior vena cava to the right heart cavities and the pulmonary circulation, indicating massive VAE. Associated patent foramen ovale was diagnosed by transesophageal echocardiography, suggesting paradoxical embolism. This case highlights the importance of caution with intraosseous access, especially when using semirigid containers and pressure-infusion devices. Emergency and intensive-care physicians should be aware of the VAE risk associated with semirigid containers to promptly recognize and treat VAE events.
静脉空气栓塞（VAE）是骨内通路一种罕见但可能危及生命的并发症。我们报告了一例57岁女性的病例，该患者因蓄意自我中毒后就诊于急诊科，随后发生了与骨内通路相关的VAE。经胸超声心动图显示急性肺心病，气泡从下腔静脉迁移至右心腔和肺循环，提示大量VAE。经食管超声心动图诊断为伴有卵圆孔未闭，提示反常栓塞。该病例强调了骨内通路操作时谨慎的重要性，尤其是在使用半刚性容器和压力输注装置时。急诊和重症监护医生应意识到与半刚性容器相关的VAE风险，以便及时识别和治疗VAE事件。
