Air embolism following removal of hemodialysis catheter. 2017

Tuncay Sahutoglu, and Tamer Sakaci, and Nuri Baris Hasbal, and Ekrem Kara, and Elbis Ahbap, and Mustafa Sevinc, and Yener Koc, and Taner Basturk, and Elif Sahutoglu, and Abdulkadir Unsal
Department of Nephrology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.

Air embolism (AE) is a rare, but serious complication that can occur in the practice of hemodialysis. In contrast to careful techniques and meticulous care during insertions and manipulations of the central catheters, awareness of the risk of AE following catheter removal is less. We aimed to analyze the clinical characteristics of the all case reports with AE after catheter removal and summarize the mechanisms, clinical consequences, treatment and prevention of AE. In addition to our case, MEDLINE database was searched for all case reports with AE following catheter removal, and the clinical, diagnostic and outcome data were analyzed. A total of 10 patients (including our case) (M/F 6/4; median age 50.5 years) were found for the analysis. Procedures for prevention of AE were reported in a few patients (Trendelenburg position 2, airtight dressing 1). The time that elapsed between catheter removals and onset of AEs was ranged from seconds to 6 hours. The most common findings were dyspnea (90%), hypoxemia (70%), and cerebral dysfunction (70%). The most common sites where air could be detected were the left ventricle (40%), pulmonary artery (30%) and right ventricle (30%). Mortality was reported in 4 (40%) cases and the remaining 6 patients had complete recovery. Blocking of air portal was not reported in any of the fatal cases. AE following catheter removal carries a major risk of mortality. Great awareness and attention to preventive procedures and appropriate care after development of AE seem mandatory.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002405 Catheterization, Central Venous Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein. Central Venous Catheterization,Venous Catheterization, Central,Catheterization, Central,Central Catheterization,Catheterizations, Central,Catheterizations, Central Venous,Central Catheterizations,Central Venous Catheterizations,Venous Catheterizations, Central
D004618 Embolism, Air Blocking of a blood vessel by air bubbles that enter the circulatory system, usually after TRAUMA; surgical procedures, or changes in atmospheric pressure. Air Embolism,Embolism, Gas,Air Embolisms,Embolisms, Air,Embolisms, Gas,Gas Embolism,Gas Embolisms
D006435 Renal Dialysis Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION. Dialysis, Extracorporeal,Dialysis, Renal,Extracorporeal Dialysis,Hemodialysis,Dialyses, Extracorporeal,Dialyses, Renal,Extracorporeal Dialyses,Hemodialyses,Renal Dialyses
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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