Transesophageal echocardiography detection of air embolism during endoscopic surgery and validity of hyperbaric oxygen therapy : Case report

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc..

INTRODUCTION: Air embolism has the potential to be serious and fatal. In this paper, we report 3 cases of air embolism associated with endoscopic medical procedures in which the patients were treated with hyperbaric oxygen immediately after diagnosis by transesophageal echocardiography. In addition, we systematically review the risk factors for air embolism, clinical presentation, treatment, and the importance of early hyperbaric oxygen therapy efficacy after recognition of air embolism.

PATIENT CONCERNS: We present 3 patients with varying degrees of air embolism during endoscopic procedures, one of which was fatal, with large amounts of gas visible in the right and left heart chambers and pulmonary artery, 1 showing right heart enlargement with increased pulmonary artery pressure and tricuspid regurgitation, and 1 showing only a small amount of gas images in the heart chambers.

DIAGNOSES: Based on ETCO2 and transesophageal echocardiography (TEE), diagnoses of air embolism were made.

INTERVENTIONS: The patients received symptomatic supportive therapy including CPR, 100% O2 ventilation, cerebral protection, hyperbaric oxygen therapy and rehabilitation.

OUTCOMES: Air embolism can causes respiratory, circulatory and neurological dysfunction. After aggressive treatment, one of the 3 patients died, 1 had permanent visual impairment, and 1 recovered completely without comorbidities.

CONCLUSIONS: While it is common for small amounts of air/air bubbles to enter the circulatory system during endoscopic procedures, life-threatening air embolism is rare. Air embolism can lead to serious consequences, including respiratory, circulatory, and neurological impairment. Therefore, early recognition of severe air embolism and prompt hyperbaric oxygen therapy are essential to avoid its serious complications.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:100

Enthalten in:

Medicine - 100(2021), 23 vom: 11. Juni, Seite e26304

Sprache:

Englisch

Beteiligte Personen:

Guo, Ji-Ling [VerfasserIn]
Wang, Han-Bing [VerfasserIn]
Wang, Hong [VerfasserIn]
Le, Yue [VerfasserIn]
He, Jian [VerfasserIn]
Zheng, Xue-Qin [VerfasserIn]
Zhang, Zhi-Hao [VerfasserIn]
Duan, Guang-Rong [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Journal Article

Anmerkungen:

Date Completed 24.06.2021

Date Revised 03.01.2023

published: Print

Citation Status MEDLINE

doi:

10.1097/MD.0000000000026304

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM326629890