Venous Air Embolism

Venous air embolism (VAE), a subset of gas embolism, is an entity with the potential for severe morbidity and mortality. Venous air embolism is a predominantly iatrogenic complication[1, 2] that occurs when atmospheric gas is introduced into the systemic venous system[3] . In the past, this medical condition was mostly associated with neurosurgical procedures conducted in the sitting position.[4, 5] More recently, venous air embolism has been associated with central venous catheterization,[3, 6, 7] penetrating and blunt chest trauma,[8, 9] high-pressure mechanical ventilation,[3] thoracocentesis,[1] hemodialysis,[3, 7] and several other invasive vascular procedures.

Venous air embolism (VAE) has also been observed during diagnostic studies, such as during radiocontrast injection for computerized tomography.[10, 11] The use of gases such as carbon dioxide and nitrous oxide during medical procedures and exposure to nitrogen during diving accidents can also result in VAE.[2] Many cases of VAE are subclinical with no adverse outcome and thus go unreported. Usually, when symptoms are present, they are nonspecific, and a high index of clinical suspicion of possible venous air embolism is required to prompt investigations and initiate appropriate therapy.