Paradoxical venous air embolism detected with point-of-care ultrasound: a case report.

Autor: Ruiz Avila HA; Cuidado Crítico, Hospital Universitario Nacional de Colombia, Bogotá D.C, Colombia.; Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia.; Universidad Militar Nueva Granada, Bogotá D.C, Colombia., García-Araque HF; Universidad Militar Nueva Granada, Bogotá D.C, Colombia.; Hospital Militar Central, Bogotá D.C, Colombia., Acosta-Gutiérrez E; Cuidado Crítico, Hospital Universitario Nacional de Colombia, Bogotá D.C, Colombia. egacostag@unal.edu.co.; Instituto de Investigaciones Clínicas, Universidad Nacional de Colombia, Bogotá, Colombia. egacostag@unal.edu.co.
Jazyk: angličtina
Zdroj: The ultrasound journal [Ultrasound J] 2022 May 18; Vol. 14 (1), pp. 19. Date of Electronic Publication: 2022 May 18.
DOI: 10.1186/s13089-022-00265-7
Abstrakt: Venous air embolism (VAE) is an uncommon event consistent in the entrainment of air from any communication between the environment and the venous vasculature that could occur during central venous catheter (CVC) manipulation, and might trigger circulatory shock within minutes depending on the amount of air embolized. We present a case of a critical care patient who presented sudden clinical hemodynamic deterioration after the removal of central venous catheter. Hemodynamic evaluation with point-of-care ultrasound (POCUS) showed bubbles in both right and left heart cavities wherewith air embolism facilitated by heart septal defect was suspected. Therefore, the patient was reintubated, supported with vasopressors and a new CVC was inserted to proceed with air aspiration. Shortly after, the patient's hemodynamic status improved in terms of vital signs stabilization. 6 h after the event with optimal perfusion markers and diminished sedation, the patient showed left hemiparesis therefore a cerebral magnetic resonance (MRI) was also performed showing hyperintensity in the right precentral gyrus, so ischemic stroke without hemorrhagic transformation diagnosis was made, because of paradoxical embolism. This case report demonstrates the value of POCUS application as a diagnostic tool in the hemodynamically unstable patient.
(© 2022. The Author(s).)
Databáze: MEDLINE
Externí odkaz: