Air embolism medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Air embolism is a medical emergency and should be treated immediately.

The mainstay of therapy for air embolism is high flow oxygen therapy with 100% oxygen.

During surgery:

• Cover surgical site
  • This prevents further air trapping^[1]
• Tilt operating table
  • This lowers the source of air entry and eliminates negative air pressure gradient^[2]
• Reverse Trendelenburg in procedures that are lower than the heart^[3]
• Jugular venous compression during cranial or facial surgery
  • This decreases distal venous pressure and eliminates further air entry from face and head^[4]

Post Surgery:

• High flow oxygen therapy/Hyperbaric oxygen therapy
  • This increases partial pressure of nitrogen and oxygen in blood leading to decrease in size of bubble and acceleration of bubble resorption^[5]
• Aspiration of air from right atrium
  • Using the Bunegin Albin catheter^[6]
  • Swan Ganz catheter is shown to be ineffective^[7]
• Hemodynamic and Cardiopulmonary resuscitation if necessary
  • Some studies have shown cardiac massage may be beneficial
    • This forces air out of pulmonary outflow tract leading to improved lateral blood flow^[8]

Template:WH Template:WS