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Air Entering The Vascular System

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Purpose:
Air embolism is a rare but potentially fatal consequence of air entering the vascular system. It can result from a wide range of procedures, including those related to vascular access in interventional radiology, in addition to open surgical procedures. We set out to review all cases of air embolism at our institution over a 25-year period, including analysis of cause, clinical signs and symptoms, treatment and prognosis.

Materials and Methods:
Institutional board review for this retrospective study was obtained. A centralized clinical data registry was searched for all cases of air embolism over a 25-year period using the ICD-9-CM code for air embolism, 958.0. Additionally, a separate database of radiology reports was searched for the terms “air embolism”, “air embolus” and other related terms over the same time period. The data were combined and the relevant medical records were reviewed. Patients with imaging evidence or high clinical suspicion of air embolism were identified. Inclusion criteria included the presence of sudden desaturation, reduced end-tidal CO2, acute cardiopulmonary compromise as defined by the need for cardiopulmonary resuscitation or vasopressors, acute neurological change including motor or sensory changes or the presence of seizures. Additionally, all patients needed to have a clearly defined antecedent event, including open, laparoscopic or endovascular procedures, central or peripheral line placement or removal (Figure 1) or an
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