Arterial Gas Embolism (Age)

Basics

Results when air bubbles enter the pulmonary venous return from ruptured alveoli, then propagate through the systemic vasculature:
- Clinical manifestations depend on location of air bubbles in systemic vasculature system
Also known as dysbaric air embolism or cerebral air embolism
Caused by overpressurization of lung tissue, causing pleural tear with air entering the vascular circulation:
- Trapped air (in lungs with closed glottis) expands on diver ascent
- Boyle law: At a constant temperature, pressure (P) is inversely related to volume (V):
  - PV = K (constant) or P₁V₁ = P₂V₂
- As pressure increases/decreases, volume decreases/increases

Pulmonary atrioventricular (AV) shunts, or as paradoxical embolism via a patent foramen ovale
Breath holding during ascent:
- Symptoms attributable to a shower of bubbles and multiple blood vessel involvement
Iatrogenically during placement of central venous pressure (CVP) lines, cardiothoracic surgery, or hemodialysis
Penetrating injuries to heart, with emergent repair of cardiac wound

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