空气栓塞是一种罕见但可能危及生命的情况。气体栓塞可以是动脉,作为肺活检的并发症,动脉导管插入术,或体外循环的体外循环,或静脉,如在静脉导管操作的情况下(尤其是在自发呼吸患者中使用中心静脉导管),加压静脉输液,或者在神经外科手术中。文献中描述了各种临床表现,从无症状病例到阻塞性休克。临床表现可能包括胸痛,呼吸困难,恶心和呕吐,改变了意识,局灶性神经功能缺损,癫痫发作,眩晕,和黑蒙。体格检查结果可能包括低血压和胸部听诊时的“磨轮杂音”。早期诊断和治疗对于改善这些患者的预后至关重要。方法和管理包括将患者置于左侧卧位和/或Trendelenburg位置以及高流量氧气。高压氧治疗是动脉气体栓塞的决定性治疗方法,这可能会减少空气栓子的大小,改善组织氧合,减少缺血性损伤。这里,我们报道一例62岁女性肥胖患者,高血压,血脂异常,并从2019年冠状病毒病(COVID-19)合并静脉气体栓塞引起的阻塞性休克中恢复过来。
Air embolism is a rare but possibly life-threatening situation. Gas embolism can be arterial, occurring as a complication of a lung biopsy, arterial catheterization, or extracorporeal circulation in the context of cardiopulmonary bypass, or venous, as in cases of venous catheter manipulation (especially with a central venous catheter in a spontaneously breathing patient), pressurized venous infusions, or in a neurosurgical context. Various clinical manifestations are described in the literature, ranging from asymptomatic cases to obstructive shock. Clinical manifestations may include chest pain, dyspnea, nausea and vomiting, altered consciousness, focal neurological deficits, seizures, vertigo, and amaurosis. Physical examination findings may include hypotension and \"mill wheel murmur\" on chest auscultation. Early diagnosis and treatment are essential to improve the outcome of these patients. Approach and management include placing the patient in the left lateral decubitus and/or Trendelenburg position and on high-flow oxygen. Hyperbaric oxygen therapy is the definitive treatment for arterial gas embolism, which may reduce air emboli size, improve tissue oxygenation, and reduce ischemic lesion. Here, we report the case of a 62-year-old female patient with obesity, hypertension, dyslipidemia, and recovering from coronavirus disease 2019 (COVID-19) with obstructive shock due to venous gas embolism.