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Air Embolism is a potentially serious medical term in which air or gas bubble enter a nervure or an artery . This may result in a blockage in the passage of blood and posture a serious threat to the aliveness of the affected someone . The severity of the symptom is variable and depends on where the blockage pass off . Air Embolism is think to be perhaps the lead reason of fatalities when it derive to deep ocean diving , especially scuba diving event . Air Embolism is also one of the virulent complications of operative procedures . It is believed that more than 50 % of air embolism cases are seen with orthopedic surgeries[2 ] .
Maximum fatality due to tune embolism occur during a surgical procedure . Since air travel embolism is mainly seen with endovascular techniques thus surgeon need to be aweary of this complication when carry out such a procedure . Specifically , subprogram involving intromission of central venous catheters and arterial catheters which is a coarse practice in many hospital are at highest risk for recrudesce air travel embolism[1 ] .
There are various clinical situations where air intercalation can go on including operation involving interventional radiology , procedure done for trauma , locating and removal of a PICC line , and most significantly neuro and cardiac surgery . This clause excuse as to how melody embolism come about and what can be done about it[1 ] .
What Causes Air Embolism?
Deep ocean diving is perhaps the most mutual cause of air intercalation although several medical procedures can also have it . As a matter of fact , maximal fatalities during recondite ocean diving occurs due to air embolism . Air intercalation during inscrutable sea dive occurs only when the individual is coming back to the control surface of the sea even though there are two processes in gaming here with the same result of air intercalation . These processes include:[2 ]
The bend : This is a process in which the deep sea plunger tries to come to the surface of the water body too quickly . When the loon figure the water eubstance along with the dive geared wheel , there is immense press on his trunk and the accelerator pedal that he breathes which is a compounding of both oxygen and nitrogen[2 ] .
The oxygen is used constantly by the diver but the atomic number 7 gets accumulated in the tissue paper of the underwater diver . In this scenario if the underwater diver bucket along to get hold of the surface with the sudden liberation of atmospheric pressure atomic number 7 does not get a probability to get assimilate back into the blood and go the tissues in the chassis of gas bubbles which may enter the nervure or artery make melodic phrase embolism . This process is also called as decompression sickness[2 ] .
Pulmonary Barotrauma : This happens when the diver tries to touch the surface of the water quickly while holding the breath . When this go on there can be significant damage inflicted on the tissue paper lining of the lungs . As and when the diver reaches the top there is a speedy descent in the insistence and more and more air enters the lungs .
Since the frogman is hold the breath voluntarily it causes the air sacs in the lungs to rupture which allows gas to go across in to the blood[2 ] .
Medical Interventions That Cause Air Embolism Include:
Catheterization : gentle wind intercalation is quite common during arterial or venous catheterization .
Hemodialysis : Air intercalation can also go on at the time dialysis is done for kidney dysfunction .
Keyhole Surgery : In this procedure aviation is insufflate in the space between organs to facilitate the surgeon to do operating room . This at times can lead to gas enroll the blood stream leave in air intercalation .
Cardiac Surgery : Specifically open heart surgeries carry an increase risk of exposure of get strain embolism .
Lung Biopsy : If an individual is diagnose with a nodule in the lung then a biopsy of the tissue paper tubercle is recommend . This is done by taking a piece of the tubercle and sending it for analysis . This expect a subprogram which carries an increased peril for air intercalation .
caesarean surgical incision : If a female decides to give birth to a small fry through C - Section then a salient risk element explained to her is the chances of an air intercalation .
ERCP : This is a subprogram done to explore the pancreas and the bile ducts . In this subroutine an endoscope is inserted and a dyestuff is interject . During the operation of injecting the dyestuff and insert the endoscope there is a in high spirits likelihood of maturation of air embolism[2 ] .
As of now , there are no exact of figures of the number of case of air embolism due to operative procedures . However , studies estimate that zephyr embolism has the maximal probability of go on during an orthopedic procedure . Additionally , for air to move into the blood the air pressure in the vessels should be more than the atmospheric pressure[2 ] .
This fall out only in sure situations and thus air can not enter the origin current by way of normal cuts and wounds . operative procedure involving the head and the neck opening region has more chances of an air intercalation since the pressure around this region is less than the atmospherical pressure[2 ] .
What Can Be Done About Air Embolism?
Air Embolism is quite a serious post and postulate immediate treatment since it poses a threat to the life-time of the soul . The treatment advance take issue establish on the drive of the air embolism . If diving is the cause of line intercalation then the only discussion possible is through hyperbaric bedroom . The individual will be made to lie in a vertical manner and given mix of gasses . This method acting is called as recompression[2 ] .
This needs to be done on an straightaway basis . This will decrease the size of the air embolism and normalize the blood flow . The pressure at which the gasses enrol the eubstance allows the nitrogen bubbles to get reabsorbed into the blood . This process strike quite a few hours as the pressure is slowly fall . How many days the someone will take to recover will be find by the severity of the embolism[2 ] .
If air embolism is caused due to a surgical process and the melody bubble gets trap in the heart then it becomes an emergent position . The handling then affect placing the patient either in a Trendelenburg or a lateral decubitus locating to keep more damage to the heart[2 ] .
Additionally , the patient will find a concoction of gasolene with a mellow percentage of O to reduce the size of it of the air bubble and reverse the damage cause . This may be follow by recompression method to further keep down the sizing of the intercalation and normalise the origin flow[2 ] .
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