Gas Embolism: Fundamentals, Diagnosis, and Treatment

Invasive medical interventions or abrupt reductions in ambient pressure can result in intravascular gas embolism. The accumulation of gas bubbles initiates a cascade of pathophysiological phenomena progressing from platelet activation to ischemia and neurological dysfunction. This review integrates current knowledge of the biophysical mechanisms of bubble nucleation, progression, and vascular occlusion into a framework aligned with the adverse physiological consequences on circulation. The discussion further addresses the present state of clinical practice, diagnostic approaches, and therapeutic interventions. Initial studies on gas embolism utilized in vivo models, and recent in vitro and in silico platforms have provided reproducible and cost-efficient experimental approaches. The initial symptoms of gas embolism often overlap with stroke, myocardial infarction, or sepsis. Reliable detection of intravascular gas bubbles is constrained by the sensitivity, resolution, and accessibility of existing imaging modalities, particularly in systemic cases. Current treatment frameworks emphasize hyperbaric oxygen therapy, while adjunct pharmacological strategies to improve clinical outcomes are under investigation. The challenges responsible for the persistent neglect of gas embolism in both clinical and academic contexts are discussed, and a forward-looking perspective on strategies to overcome these barriers is presented.