5-Minute Clinical Consult: Arterial Gas Embolism

Arterial Gas Embolism

Etiology

Cerebral air embolism:
- Air bubbles occlude the brain vasculature.
- Intracranial pressure (ICP) increases.
- Unequal distribution of blood in the brain causes hyperemia and ischemia.
- Small bubbles irritate vascular wall, causing breakdown of blood–brain barrier; small size allows rapid absorption and may cause only brief interruption of cerebral blood flow.
- Larger air bubbles take longer to absorb (up to several hours) and can cause primary ischemic injury with diffuse brain edema and increased ICP.
Coronary air embolism is caused by obstruction of coronary arteries by an air bubble.
- Temporary ischemia of myocardium
- Labile blood pressure (BP)
- Arrhythmias
- Cardiac failure and/or arrest
Obstruction is possible in any artery. Small emboli in the vessels of skeletal muscles and viscera are well tolerated.

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