ArticleEuropean journal of case reports in internal medicine2020
Recurring Asystole and Paradoxical Air Embolization in a Patient with a Patent Foramen Ovale Treated with Home Parenteral Nutrition.
Article in European journal of case reports in internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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- Air embolism during unsuccessful transcatheter closure of secundum atrial septal defect in a patient with an undetected left-sided inferior vena cava.Forensic science, medicine, and pathology · 2025Article
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5 authors at 1 institution in 1 country.
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Abstract
Home parenteral nutrition is a therapeutic option for chronic intestinal failure. A tunnelled central venous catheter is commonly used for self-application of nutrition and hydration over a long period of time; that is, months or years. Air embolization within the venous circulation can be caused by inconsistent self-handling of the catheter in combination with air bubbles in the infusion set. Paradoxical air embolization within the brain and coronary arteries together with catheter perforation is a rare medical and technical complication. The authors report the case of a 63-year-old woman with type 3 chronic intestinal failure treated with home parenteral nutrition. During the first year of treatment and use of the catheter a fatal complication occurred. The patient experienced recurring asystolic episodes and strokes with monoplegia during flushing of the catheter. Although 2 resuscitations were successful, the third was not, and the patient died. The cause of these life-threatening complications was an unknown patent foramen ovale, with paradoxical air embolization within the coronary and brain arteries. The authors discuss the clinical consequences of arterial and venous air embolization, the differences between these and the therapeutic algorithm with a link to practice. LEARNING POINTS: Home parenteral nutrition using a Hickman central venous catheter is a therapeutic option for chronic intestinal failure.Paradoxical air embolization is a rare complication with an unknown patent foramen ovale.A very small volume of air (0.5-3 ml) in coronary or brain arteries can cause fatal complications such as asystole and brain ischaemia.
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