Arterial Gas Embolism (Age)
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- 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