| Systemic gas embolism complicating pulmonary contusion. Diagnosis and management using transesophageal echocardiography. | |
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MedLine Citation:
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PMID: 7633748 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Systemic air embolism has been frequently reported after penetrating thoracic trauma. In blunt thoracic trauma, systemic air embolism has been rarely diagnosed, and then only after an invasive procedure such as thoracotomy. Transesophageal echocardiography has been recently introduced for the early assessment of trauma patients and is considered a sensitive noninvasive procedure to diagnose air embolism. We report three cases of systemic air embolism in patients with pulmonary contusion secondary to a blunt thoracic trauma requiring controlled ventilation. Transesophageal echocardiography was performed for evaluation of hemodynamic instability, and it showed air bubbles in the left atrium and left ventricle during the insufflation phase, which disappeared during apnea. A decrease in airway pressure (release of PEEP, low tidal volume, high frequency jet ventilation) significantly reduced the systemic air embolism. We concluded that systemic air embolism can occur after blunt thoracic trauma, and transesophageal echocardiography enables a rapid and accurate diagnosis that may be useful for therapeutic management. |
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Authors:
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M Saada; J P Goarin; B Riou; J J Rouby; Y Jacquens; R Guesde; P Viars |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: American journal of respiratory and critical care medicine Volume: 152 ISSN: 1073-449X ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 1995 Aug |
Date Detail:
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Created Date: 1995-09-14 Completed Date: 1995-09-14 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 812-5 Citation Subset: AIM; IM |
Affiliation:
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Department of Anesthesiology and Critical Care, Groupe Hospitalier Pitié-Salpêtrière, Paris VI University, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Contusions / complications*, ultrasonography* Echocardiography, Transesophageal* Embolism, Air / etiology, therapy, ultrasonography* Fatal Outcome Female Heart Diseases / etiology, ultrasonography High-Frequency Jet Ventilation Humans Lung / ultrasonography* Lung Injury* Male Middle Aged Positive-Pressure Respiration Thoracic Injuries / complications, ultrasonography Tidal Volume Wounds, Nonpenetrating / complications, ultrasonography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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