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Massive air embolism: a case report

G S Adhikary¹, S R Massey

¹Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor 48109-0048, USA.

Journal of Clinical Anesthesia

|April 4, 1998

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A case of massive air embolism during pressurized fluid infusion highlights risks from air in manufacturer-filled bags. Anesthesiologists must meticulously de-air bags, and manufacturers should provide air-free solutions to reduce this danger.

Area of Science:

Anesthesiology
Patient Safety
Medical Devices

Background:

Pressurized infusion systems are common in clinical practice.
Fluid bags from manufacturers can contain significant volumes of air.
Air embolism is a rare but serious complication of fluid infusion.

Observation:

A patient experienced massive air embolism during fluid infusion under pressure.
The event was linked to air present in the manufacturer-supplied fluid bag.
The pressurized infusion system facilitated the rapid introduction of air into the patient's circulation.

Findings:

Air in fluid infusion bags poses a substantial risk of air embolism, especially with pressurized systems.
Inadequate de-airing of infusion bags before use is a critical contributing factor.

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Manufacturer-related air contamination in fluid products is a preventable source of risk.

Implications:

Anesthesiologists must exercise extreme diligence in de-airing all intravenous fluid bags prior to administration.
There is a need for improved quality control by manufacturers to supply air-free crystalloid solutions.
Implementing these measures can significantly decrease the incidence of infusion-related air embolism.