Air EmbolismDRG cew 078

Mean LOS: 7.8 days

Description: MEDICAL: Pulmonary Embolism air embolism is an obstruction in a vein or artery caused by a bubble of gas. Air enters the circulatory system when the pressure gradient favors movement of air or gas from the environment into the blood. A venous air embolism is the most common form of air embolism. It occurs when air enters the venous circulation, passes through the right side of the heart, and then proceeds to the lungs. In relatively small amounts, the lungs can filter the air; it is absorbed without complications. When large amounts of air (80 to 100 mL) are introduced into the body, however, the lungs no longer have the capacity to filter the air, and the patient has serious or even lethal complications. One of the most serious complications is when the large air bubble blocks the outflow of blood from the right ventricle into the lungs, preventing the blood from moving forward. The patient develops cardiogenic shock because of insufficient cardiac output. Experts have found that the risk from air embolism increases as both the volume and the speed of air injection increase.

An arterial embolism occurs when air gains entry into the pulmonary venous circulation and then passes through the heart and into the systemic arterial circulation. An arterial embolism can also form in the patient who has a venous embolism and a right-to-left shunt (often caused by a septal defect in the heart) so that the air bubble moves into the left ventricle without passing through the lungs. Pulmonary capillary shunts can produce the same effect. The arterial embolism may cause serious or even lethal complications in the brain and heart. Scientists have found that as little as 0.05 mL of air in the coronary arteries can cause death.

The frequency of clinically recognized venous air embolism following central line insertion is less than 2%, but in that setting has a mortality rate as high as 30%.

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