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Air embolism

Authors
Liza C O'Dowd, MD
Mark A Kelley, MD
Section Editor
Jess Mandel, MD
Deputy Editor
Geraldine Finlay, MD

INTRODUCTION

Air embolism is an uncommon, but potentially catastrophic, event that occurs as a consequence of the entry of air into the vasculature.

The etiology, pathophysiology, clinical features, diagnosis, treatment, and prognosis of air embolism are reviewed here. Embolization of thrombi, amniotic fluid, fat, or tumor is discussed separately. (See "Overview of acute pulmonary embolism in adults" and "Amniotic fluid embolism syndrome" and "Fat embolism syndrome" and "Pulmonary tumor embolism".)

ETIOLOGY

Air embolism can be venous or arterial. Surgery, trauma, vascular interventions, and barotrauma from mechanical ventilation and diving are the most common causes of air embolism [1-4]. These and other less common causes are listed in the table (table 1). The causes of venous and arterial embolism differ depending on the portal of entry of air. The etiology, definition, and pathophysiology of venous and arterial embolism, are discussed in the sections below. (See 'Surgery and trauma' below and 'Intravascular catheters' below and 'Barotrauma' below and 'Other' below and 'Terminology and pathophysiology' below.)

Surgery and trauma

Neurosurgical and otolaryngological procedures — Venous air embolism complicates neurosurgical and otolaryngological procedures more often than other types of surgical procedures. The estimated incidence of venous air embolism during neurosurgical procedures ranges from 10 percent (for surgical patients in the prone position) to 80 percent (for patients undergoing repair of cranial synostosis in Fowler's position, ie, sitting upright) [1,5-9].

Other surgical or procedural interventions — Venous air embolism has been reported as a rare complication in the following surgeries or procedures:

                                    

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Literature review current through: Jul 2015. | This topic last updated: Apr 30, 2015.
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