Air embolism

Introduction Air embolism is a disease caused by a gas embolus originating from the lungs that blocks the cerebral blood vessels. It is usually caused by excessive inflation of the lungs caused by the expansion of the lungs when the surrounding pressure is reduced (such as when rising from deep water diving). For pain and / or nervous system symptoms. Air embolism refers to air entering the blood circulation to the lungs, blocking the main pathway of the pulmonary artery, causing severe shock. The disease is extremely rare and can be produced during childbirth or during childbirth (including abortion).

Cause

Excessive lung inflation, a common cause of this arterial gas embolism, is mostly caused by breath holding when the scuba diving rises. The escape of air in deep water accelerates the event. If the swimmer enters the air source, even if only one breath is taken under water, the depth of the swimming pool is sufficient to cause gas embolism. When rising, any deep-absorbed air can swell, and if it is not allowed to escape freely, it can cause lung expansion and alveolar pressure to rise, which may cause gas to enter the pulmonary veins. If the gas reaches the carotid artery, embolization of the cerebral blood vessels is almost inevitable.

an examination

Related inspection

Chest perspective

Electrocardiogram

Electrocardiographic changes in acute pulmonary heart disease may occur, including signs of pulmonary P wave, right bundle branch block, and right heart strain.

2. Central venous pressure measurement and aspiration of air

At the time of air embolism, the central venous pressure was measured and the air was drawn, which was diagnosed.

3. Heart cavity puncture

When the right ventricular cavity is puncture, the blood drawn by the heart is foamy. It must be pointed out that cardiac puncture must be carried out with care and should not be used under normal circumstances, but it can be used in the rescue of cardiac arrest.

Differential diagnosis

Differential diagnosis of air embolism:

1. Coronary embolism: Arterial embolization refers to the detachment of the embolus from the heart or the proximal arterial wall or from the outside into the artery, pushed to the distal side by the blood flow, blocking the blood flow of the artery and causing ischemia or even necrosis of the limb or internal organs. Pathological process. Acute myocardial infarction (acutemyocardialinfarction) refers to sudden complete occlusion of the coronary artery, ischemia, injury and necrosis of the myocardium, and an acute ischemic heart disease characterized by severe chest pain, electrocardiogram and dynamic changes of myocardial enzymology. Most of the underlying lesions are coronary atherosclerosis, and a few are other lesions such as acute coronary embolism.

2, limb embolism: arterial embolization refers to the embolus from the heart or the proximal arterial wall, or from the outside into the artery, pushed by the bloodstream to the far side, blocking the arterial blood flow and causing ischemia or even necrosis of the limb or internal organs Pathological process. When the peripheral arteries are embolized, the affected limbs are painful, pale, distant arterial pulsations disappear, cold, numbness, and movement disorders. The onset of the disease is rapid, and the limbs and even the life are threatened after the onset of the disease. It is important to diagnose and count the appropriate treatments every second.

3, venous embolism: venous embolism is due to venous occlusion caused by excessive blood viscosity in the vein, usually can cause varicose veins.

4, body pulmonary circulatory embolism: body pulmonary circulatory embolism refers to the body or pulmonary artery blocked by blood flow caused by emboli. Mainly thromboembolism. It can also be caused by air, fat, or septic emboli.

5, cardiopulmonary embolism: cardiopulmonary embolism can cause changes in cardiopulmonary function, the degree of change depends on the extent of pulmonary occlusion, speed, original heart and lung function status. Light heart and lung function can be no significant changes, severe cases can lead to hypoxemia, hypocapnia, alkaliemia, increased pulmonary circulation resistance, pulmonary hypertension, acute right ventricular dysfunction.

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