Document Detail

Systemic gas embolism complicating pulmonary contusion. Diagnosis and management using transesophageal echocardiography.
MedLine Citation:
PMID:  7633748     Owner:  NLM     Status:  MEDLINE    
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.
M Saada; J P Goarin; B Riou; J J Rouby; Y Jacquens; R Guesde; P Viars
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
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:
Created Date:  1995-09-14     Completed Date:  1995-09-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  812-5     Citation Subset:  AIM; IM    
Department of Anesthesiology and Critical Care, Groupe Hospitalier Pitié-Salpêtrière, Paris VI University, France.
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MeSH Terms
Contusions / complications*,  ultrasonography*
Echocardiography, Transesophageal*
Embolism, Air / etiology,  therapy,  ultrasonography*
Fatal Outcome
Heart Diseases / etiology,  ultrasonography
High-Frequency Jet Ventilation
Lung / ultrasonography*
Lung Injury*
Middle Aged
Positive-Pressure Respiration
Thoracic Injuries / complications,  ultrasonography
Tidal Volume
Wounds, Nonpenetrating / complications,  ultrasonography*

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