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An Unexpected Complication: Obstructive Shock Secondary to Venous Air Embolism
Francisco Dá Mesquita Faustino1, Ana Sofia Costa2, Isabel Ferreira1
1Critical Care Medicine, Hospital Prof. Doutor Fernando da Fonseca, Lisboa, PRT.
Cureus
|September 16, 2022
Summary
Air embolism is a rare, life-threatening condition. This case highlights obstructive shock from venous gas embolism in a patient recovering from COVID-19, emphasizing prompt diagnosis and management.
Area of Science:
- Medical Case Reports
- Cardiovascular Medicine
- Pulmonology
Background:
- Air embolism, a rare but serious condition, can be arterial or venous.
- It may arise from various medical procedures or conditions, including catheter manipulation and cardiopulmonary bypass.
- Clinical presentations range from asymptomatic to obstructive shock, with diverse neurological and cardiovascular symptoms.
Observation:
- The case involved a 62-year-old female with multiple comorbidities, including obesity, hypertension, dyslipidemia, and recent recovery from COVID-19.
- The patient presented with obstructive shock attributed to venous gas embolism.
- Physical examination revealed hypotension and a characteristic
- mill wheel murmur
- on chest auscultation.
Findings:
- Venous gas embolism can lead to severe hemodynamic compromise, including obstructive shock.
- Management strategies include patient positioning (left lateral decubitus and Trendelenburg) and high-flow oxygen.
- Hyperbaric oxygen therapy is the definitive treatment for arterial gas embolism, aiming to reduce emboli size and improve tissue oxygenation.
Implications:
- This case underscores the critical importance of recognizing venous gas embolism as a cause of obstructive shock, particularly in patients with relevant risk factors.
- Effective management, including supportive measures and potentially hyperbaric oxygen therapy, can significantly impact patient survival and recovery.
- Further research into the specific mechanisms and optimal treatment strategies for venous gas embolism in diverse patient populations is warranted.
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