Air embolism and volume status

Q: Which of the following increases the risk of air embolism during central venous catheter (CVC) insertion or removal? (select one)

A) Hypovolemia 
B) Hypervolemia 


 Answer: A

Any factor which reduces the central venous pressure below atmospheric pressure places the patient at particular risk for entraining air rapidly. Two such factors during insertion or removal are 

• hypovolemia during insertion, and 
• upright position during removal 

Some other risk factors for air embolism are broken CVC, detached connections (which accounts for 60 to 90 percent of episodes), and deep inspiration during insertion or removal.

#procedures


References:

King MB, Harmon KR. Unusual forms of pulmonary embolism. Clin Chest Med 1994; 15:561.

Kashuk JL, Penn I. Air embolism after central venous catheterization. Surg Gynecol Obstet 1984; 159:249.