Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Massive Air Embolism after Contrast-enhanced Computed Tomography

조영증강 흉부전산화 단층촬영 후 발생한 대량의 공기 색전증 1예

  • Park, Byeong Chool (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Kil, Ho (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Park, Chan Sun (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Jeong, Jee In (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Choi, Eun Young (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Shin, Yoon Mi (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Lee, Ki Man (Department of Internal Medicine, College of Medicine, Chungbuk National University) ;
  • Kim, Sung Jin (Department of Radiology, College of Medicine, Chungbuk National University) ;
  • Choe, Kang Hyeon (Department of Internal Medicine, College of Medicine, Chungbuk National University)
  • 박병출 (충북대학교 의과대학 내과학교실) ;
  • 길호 (충북대학교 의과대학 내과학교실) ;
  • 박찬선 (충북대학교 의과대학 내과학교실) ;
  • 정지인 (충북대학교 의과대학 내과학교실) ;
  • 최은영 (충북대학교 의과대학 내과학교실) ;
  • 신윤미 (충북대학교 의과대학 내과학교실) ;
  • 이기만 (충북대학교 의과대학 내과학교실) ;
  • 김성진 (충북대학교 의과대학 영상의학과교실) ;
  • 최강현 (충북대학교 의과대학 내과학교실)
  • Received : 2007.06.14
  • Accepted : 2007.07.11
  • Published : 2007.08.30
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Abstract

A venous air embolism is a complication of various venous access procedures such as contrast-enhanced computed tomography (CECT). Although most cases of iatrogenic venous air embolisms during CECT involve a few milliliters of air and are asymptomatic, a massive venous air embolism can be fatal. We report a case of a massive intraventricular air embolism after CECT with a review of the literature regarding the pathophysiology and treatment of air embolisms.

정맥 내 공기 색전은 조영제 주입과 관련된 합병증으로 알려져 있다. 대부분의 경우 색전된 공기의 양이 적고 증상이 없으나 대량의 공기 색전은 치명적일 수 있다. 저자들은 흉부 CT 촬영 중 조영제 주입과 관련하여 발생한 대량의 우심실 내 공기 색전과 보존적 치료로 후유증 없이 회복된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Ie SR, Rozans MH, Szerlip HM. Air embolism after intravenous injection of contrast material. South Med J 1999;92:930-3 https://doi.org/10.1097/00007611-199909000-00019
  2. van Hulst RA, Klein J, Lachmann B. Gas embolism: pathophysiology and treatment. Clin Physiol Funct Imaging 2003;23:237-46 https://doi.org/10.1046/j.1475-097X.2003.00505.x
  3. Muth CM, Shank ES. Gas embolism. N Engl J Med 2000;342:476-82 https://doi.org/10.1056/NEJM200002173420706
  4. Sviri S, Woods WP, van Heerden PV. Air embolism: a case series and review. Crit Care Resusc 2004;6:271-6
  5. Sakai O, Nakashima N, Shinozaki T, Furuse M. Air bubbles in thr subclavian or internal jugular veins: a common finding on contrast-enhanced CT. Neuroradiology 1998;40:258-60 https://doi.org/10.1007/s002340050580
  6. Woodring JH, Fried AM. Nonfatal venous air embolism after contrast-enhanced CT. Radiology 1988;167:405-7 https://doi.org/10.1148/radiology.167.2.3357948
  7. Price DB, Nardi P, Teitcher J. Venous air embolization as a complication of pressure injection of contrast media: CT findings. J Comput Assist Tomogr 1987;11:294-5 https://doi.org/10.1097/00004728-198703000-00020
  8. Groell R, Schaffler GJ, Rienmueller R, Kern R. Vascular air embolism: location, frequency, and cause on electron-beam CT studies of the chest. Radiology 1997;202:459-62 https://doi.org/10.1148/radiology.202.2.9015074
  9. Imai S, Tamada T, Gyoten M, Yamashita T, Kajihara Y. Iatrogenic venous air embolism caused by CT injector: from a risk management point of view. Radiat Med 2004;22:269-71
  10. Lee H. Massive intraventricular air embolism after contrast-enhanced CT: report of two cases. J Kor Radiol Soc 2006;54:349-52 https://doi.org/10.3348/jkrs.2006.54.5.349
  11. Vesely TM. Air embolism during insertion of central venous catheters. J Vasc Interv Radiol 2001;12:1291-5 https://doi.org/10.1016/S1051-0443(07)61554-1
  12. Gottdiener JS, Papademetriou V, Notargiacomo A, Park WY, Cutler DJ. Incidence and cardiac effects of systemic venous air embolism. Echocardiographic evidence of arterial embolization via noncardiac shunt. Arch Intern Med 1988;148:795-800 https://doi.org/10.1001/archinte.148.4.795
  13. Pham KL, Cohen AJ. Iatrogenic venous air embolism during contrast enhanced computed tomography: a report of two cases. Emerg Radiol 2003;10:147-51 https://doi.org/10.1007/s10140-003-0270-y
  14. Kytta J, Tanskanen P, Randell T. Comparison of the effects of controlled ventilation with 100% oxygen, 50% oxygen in nitrogen, and 50% oxygen in nitrous oxide on responses to venous air embolism in pigs. Br J Anaesth 1996;77:658-61 https://doi.org/10.1093/bja/77.5.658
  15. Blanc P, Boussuges A, Henriette K, Sainty JM, Deleflie M. Latrogenic cerebral air embolism: importance of an early hyperbaric oxygenation. Intensive Care Med 2002;28:559-63 https://doi.org/10.1007/s00134-002-1255-0