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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Air embolism medical therapy

Introduction

Overview

Overview

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

Medical Therapy

Medical Therapy

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]
References

References

  1. ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). “Diagnosis and treatment of vascular air embolism”. Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter |month= ignored (help)
  2. ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). “Diagnosis and treatment of vascular air embolism”. Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter |month= ignored (help)
  3. ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). “Diagnosis and treatment of vascular air embolism”. Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter |month= ignored (help)
  4. ↑ T. Takahashi, K. Yano, T. Kimura, T. Komatsu & Y. Shimada (1997). “Prevention of venous air embolism by jugular venous compression under superior sagittal sinus pressure monitoring in a brachycephalic patient during craniofacial reconstruction”. Paediatric anaesthesia. 7 (3): 259–260. PMID 9189976.
  5. ↑ Marek A. Mirski, Abhijit Vijay Lele, Lunei Fitzsimmons & Thomas J. K. Toung (2007). “Diagnosis and treatment of vascular air embolism”. Anesthesiology. 106 (1): 164–177. PMID 17197859. Unknown parameter |month= ignored (help)
  6. ↑ P. S. Colley & A. A. Artru (1989). “Bunegin-Albin catheter improves air retrieval and resuscitation from lethal venous air embolism in upright dogs”. Anesthesia and analgesia. 68 (3): 298–301. PMID 2919770. Unknown parameter |month= ignored (help)
  7. ↑ R. F. Bedford, W. K. Marshall, A. Butler & J. E. Welsh (1981). “Cardiac catheters for diagnosis and treatment of venous air embolism: a prospective study in man”. Journal of neurosurgery. 55 (4): 610–614. doi:10.3171/jns.1981.55.4.0610. PMID 6792326. Unknown parameter |month= ignored (help)
  8. ↑ J. A. ERICSSON, J. D. GOTTLIEB & R. B. SWEET (1964). “CLOSED-CHEST CARDIAC MASSAGE IN THE TREATMENT OF VENOUS AIR EMBOLISM”. The New England journal of medicine. 270: 1353–1354. doi:10.1056/NEJM196406182702507. PMID 14140269. Unknown parameter |month= ignored (help)

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