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      Air Embolism

      The causes of venous air embolisms are preventable

      Read how health care professionals can reduce the risk significantly and why this is a particularly important task in pediatrics.

      air embolism bubbles

      Just 0.5-1mL of air in the pulmonary vein can cause a cardiac arrest.1

      Why is an Air Embolism a Risk in Pediatrics?

      In children and especially preterm babies and neonates, the smallest amount of air can lead to an air embolism with fatal consequences.9 Pediatric and neonatal patients suffering from a persistent foramen ovale (PFO) or patent ductus arteriosus (DA) are particularly affected. If air passes through the PFO or DA, there is also a risk of a systemic (arterial) air embolism in addition to the risk of a venous air embolism.10

      The effects of small total volumes of air can be physiological changes, such as:10

      • Mechanical pulmonary vascular obstruction
      • Pulmonary vasoconstriction
      • Hypoxemia
      • Increased airway resistance
      • Decreased lung compliance
      • Myocardial ischemia
         

      In pediatric neurosurgery, a venous air embolism (VAE) is more common when the head is above heart level, such as in the sitting position. The incidence of these cases in children has been reported to be as high as 33%.10, 11

      Air entrainment is dependent upon the magnitude of the negative pressure developed between the site of entry and the right heart. Therefore, the sitting position represents a particular risk for an air embolism. Air entry is also possible in other surgical positions if the potential for a negative pressure gradient exists.10

      In addition to neurosurgery, air emboli have also been reported in children during the diagnostic radiological procedures arthrography, arteriography, cisternal air myelography and pneumoencephalography.10

      “Of nine reported cases of venous air emboIism in children during these […] procedures, seven patients died.”10

      Functionality of an IV filter to prevent air embolism.

      inline IV filter

      Risk Prevention in Pediatrics & Neonatology

      Do you need more information about pediatrics or are you interested in our pediatric products? 

      Get in contact

      Pediatrics & Neonatology

      B. Braun Melsungen AG

      Carl-Braun-Str. 1

      34212 Melsungen,

      Germany

      [1] Ho AMH. Is Emergency Thoractomy Always the Most Appropriate Immediate Intervention for Systematic Air Embolism After Lung Trauma? Chest. 1999;116(1):234-7.

      [2] McCarthy C, Behravesh S, Naidu S, Oklu R. Air Embolism: Practical Tips for Prevention and Treatment. Clin Med. 2016;5(11):93.

      [3] Cook LS. Infusion-related air embolism. J Infus Nurs 2013;36(1):26-36.

      [4] Gabriel J. Infusion therapy. Part two: Prevention and management of complications. Nurs Stand 2008;22(32):41-8.

      [5] Lee PT, Thompson F, Thimbleby H. Analysis of infusion pump error logs and their significance for health care. Br J Nurs 2012;21(8):12-20.

      [6] Obermayer A. Physikalisch-technische Grundlagen der Infusionstechnik – Teil 2. Medizintechnik 1994;114(5):185-190.

      [7] Zoremba N, Gruenewald C, Zoremba M, Rossaint R, Schaelte G. Air elimination capability in rapid infusion systems. Anaesthesia 2011;66(11):1031-4.

      [8] Suwanpratheep A, Siriussawakul A. Inadvertent venous air embolism from pressure infuser bag confirmed by transesophangeal echocardiography. J Anesthe Clinic Res 2011;2(10).

      [9] Levy I, Mosseri R, Garty B. Peripheral intravenous infusion – another cause of air embolism, Acta Paediatr. 1996 Mar;85(3):385–6.

      [10] Porter SS, Boyd RC, Albin MS. Venous air embolism in a child undergoing posterior fossa craniotomy: a case report. Can Anaesth Soc J. 1984 Jan;31(1):86-90. 

      [11] Sriganesh K, Mittal M, Jadhav T. Venous Air Embolism. Journal of Neurosurgical Anesthesiology 2016 Jan;28(1):85-6.

      [12] Phillips LD, Gorski LA. Infusion equipment – filters. In: Phillips LD, Gorski LA. Manual of I.V. therapeutics – evidence-based practice of infusion therapy. Philadelphia: Davis Company. 2014;265-268

      [13] Hadaway L. Infusion therapy equipment – Infusion filter. In: Alexander M. Infusion Nurses Society.Infusion nursing - an evidence-based approach. Philadelphia, Pa. [u.a.]: Saunders Elsevier. 2010;403-407