pulmonary disorders
Nonthrombotic Pulmonary Embolism
Air embolism
Air embolism is caused by introduction of large amounts of air into systemic veins or into the right side of the heart, which then move to the pulmonary arterial system. Pulmonary outflow tract obstruction may occur, which can be rapidly fatal. Causes include Surgery Blunt trauma Defective or uncapped venous catheters Errors occurring during insertion or removal of central venous catheters Treatment includes placement of the patient in the left lateral decubitus position, preferably in the Trendelenburg position (ie, head lower than the feet), to trap air in the apex of the right ventricle and thus prevent brain embolism if there is a right-to-left shunt or right ventricular and pulmonary artery outflow obstruction. Supportive measures are also needed. Rapid decompression after underwater diving may cause microbubble formation in the pulmonary circulation, a different problem, which results in endothelial damage, hypoxemia, and diffuse infiltrates (see Arterial Gas Embolism ). 