The presentation of an air embolus depends on its size, its rate of development and the patient's underlying conditions. It should be included in the differential diagnosis of just about any unexpected perioperative event.


The diagnosis of perioperative air embolism involves:

(1) onset of one or more clinical findings (see below)

(2) recognition of one or more risk factors for air embolism (see previous section)

(3) objective evidence, often based on the results of an imaging study


Clinical findings that can be seen with an air embolism:

(1) unexplained hypotension

(2) unexplained shortness of breath and/or cyanosis

(3) sudden gasping

(4) unexplained decrease in end-tidal carbon dioxide (ET-CO2)

(5) unexplained hypoxemia with reduction in PaO2

(6) sudden chest pain or unexpected signs of acute myocardial infarction

(7) unexplained bradycardia

(8) visible air bubbling at the operative site

(9) air in retinal blood vessels

(10) unexplained stroke or seizure

(11) cardiac arrest


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