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Air Embolism: Resource Center

A compilation of journals, case studies and articles about Air Embolism.

Pediatric

Infant death due to air embolism from peripheral venous infusion

Sowell MW, Lovelady CL, Brogdon BG, Wecht CH. Infant death due to air embolism from peripheral venous infusion. J Forensic Sci. 2007 Jan;52(1):183-8.

http://www.ncbi.nlm.nih.gov/pubmed/17209934

Probable venous air embolism during epidural placement in an infant

Swartz N, Eisenkraft JB. Probable venous air embolism during epidural placement in an infant. Anesth Analg 1993;76:1136–8.

http://www.ncbi.nlm.nih.gov/pubmed/8484518

Shunt lesions

Chang AC, Wells W. Shunt lesions. In: Chung AC, Hanley FL, Wernovsky G, Wassell DL, editors. Pediatric cardiac intensive care. Philadelphia: Saunders, 2005:207–8.

Diagnosis & Treatment

Diagnosis and treatment of vascular air embolism

Mirski MA, Lele AV, Fitzsimmons L, Toung TJ. Diagnosis and treatment of vascular air embolism. Anesthesiology. 2007 Jan;106(1):164-77. Review.

http://www.ncbi.nlm.nih.gov/pubmed/17197859

Acute management of vascular air embolism

Shaikh N, Ummunisa F. Acute management of vascular air embolism. Journal of Emergencies, Trauma and Shock. 2009;2(3):180-185.doi:10.4103/0974-2700.55330.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776366/

General Review Articles

Gas Embolism

Muth CM, Shank ES. Gas embolism. N Engl J Med. 2000 Feb 17;342(7):476-82. Review.

http://www.ncbi.nlm.nih.gov/pubmed/10675429

Prevention and management of air in an IV infusion system

von Jürgensonn S. Prevention and management of air in an IV infusion system. Br J Nurs. 2010 May 27-Jun 9;19(10):S28-30.

http://www.ncbi.nlm.nih.gov/pubmed/20622771

Venous air embolism

O'Quin RJ, Lakshminarayan S. Venous air embolism. Arch Intern Med. 1982 Nov;142(12):2173-6.

http://www.ncbi.nlm.nih.gov/pubmed/7138162

Venous air embolism during home infusion therapy

Laskey AL, Dyer C, Tobias JD. Venous air embolism during home infusion therapy. Pediatrics. 2002 Jan;109(1):E15.

http://www.ncbi.nlm.nih.gov/pubmed/11773583

Venous air embolism: clinical and experimental considerations

Orebaugh SL. Venous air embolism: clinical and experimental considerations. Crit Care Med. 1992 Aug;20(8):1169-77. Review.

http://www.ncbi.nlm.nih.gov/pubmed/1643897

The pathology of venous air embolism

Hartveit F, Lystad H, Minken A. The pathology of venous air embolism. Br J Exp Pathol. 1968 Feb;49(1):81-6.

http://www.ncbi.nlm.nih.gov/pubmed/5640639

Cardiopulmonary effects of intravenous gas embolism; with special reference to fate of intravascular gas bubbles

Oyama Y, Spencer MP. Cardiopulmonary effects of intravenous gas embolism; with special reference to fate of intravascular gas bubbles. Jpn Circ J. 1971 Dec;35(12):1541-9.

http://www.ncbi.nlm.nih.gov/pubmed/5172474

Procedure-related serious adverse events among home hemodialysis patients: a quality assurance perspective

Wong B, Zimmerman D, Reintjes F, Courtney M, Klarenbach S, Dowling G, Pauly RP. Procedure-related serious adverse events among home hemodialysis patients: a quality assurance perspective. Am J Kidney Dis. 2014 Feb;63(2):251-8. doi: 10.1053/j.ajkd.2013.07.009. Epub 2013 Aug 30. Review.

http://www.ncbi.nlm.nih.gov/pubmed/23993152

Long-term outcome of iatrogenic gas embolism

Bessereau J, Genotelle N, Chabbaut C, Huon A, Tabah A, Aboab J, Chevret S, Annane D. Long-term outcome of iatrogenic gas embolism. Intensive Care Med. 2010 Jul;36(7):1180-7. doi: 10.1007/s00134-010-1821-9. Epub 2010 Mar 11

http://www.ncbi.nlm.nih.gov/pubmed/20221749

Massive venous air embolism

Marchand P, Van Hasselt, Luntz CH. Massive venous air embolism. S Afr Med J. 1964 Mar 28;38:202-8.

http://www.ncbi.nlm.nih.gov/pubmed/14133044

Pulmonary (venous) air embolism

Durant TM, Long J, Oppenheimer MJ. Pulmonary (venous) air embolism. Am Heart J. 1947 Mar;33(3):269-81

http://www.ncbi.nlm.nih.gov/pubmed/20286347

Venous air embolism: a review.

Palmon SC, Moore LE, Lundberg J, Toung T. Venous air embolism: a review. J Clin Anesth. 1997 May;9(3):251-7. Review.

http://www.ncbi.nlm.nih.gov/pubmed/9172037

Air Embolism ? : Don’t worry it was just a bubble….

Laidlow, Kate. Air Embolism ? : Don’t worry it was just a bubble…. IVNNZ Newsletter. 2011.

http://www.ivnnz.co.nz/newsletter/Articles/CVC-Complications

Liability Related to Peripheral Venous and Arterial Catheterization: A Closed Claims Analysis

Bhananker SM, Liau DW, Kooner PK, Posner KL, Caplan RA, Domino KB. Liability related to peripheral venous and arterial catheterization: a closed claims analysis. Anesth Analg. 2009 Jul;109(1):124-9. doi: 10.1213/ane.0b013e31818f87c8.

https://www.ncbi.nlm.nih.gov/pubmed/19377051

Injuries and Liability Related to Central Vascular Catheters: A Closed Claims Analysis

Domino KB, Bowdle TA, Posner KL, Spitellie PH, Lee LA, Cheney FW. Injuries and liability related to central vascular catheters: a closed claims analysis. Anesthesiology. 2004 Jun;100(6):1411-8. Review.

https://www.ncbi.nlm.nih.gov/pubmed/15166560

Microbubbles: pathophysiology and clinical implications.

Barak, Michal, and Yeshayahu Katz. "Microbubbles: pathophysiology and clinical implications." CHEST Journal 128.4 (2005): 2918-2932.

https://www.ncbi.nlm.nih.gov/pubmed/16236969

Pathophysiology and clinical implications of microbubbles during hemodialysis.

Barak M, Nakhoul F, Katz Y. Pathophysiology and clinical implications of microbubbles during hemodialysis. Semin Dial. 2008 May-Jun; 21(3):232-8. doi: 10.1111/j.1525-139X.2008.00424.x. Review.

https://www.ncbi.nlm.nih.gov/pubmed/18363602

Mechanotransductional Basis of Endothelial Cell Response to Intravascular Bubbles

Klinger AL, Pichette B, Sobolewski P, Eckmann DM. Mechanotransductional Basis of Endothelial Cell Response to Intravascular Bubbles. Integrative biology : quantitative biosciences from nano to macro. 2011;3(10):1033-1042. doi:10.1039/c1ib00017a.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3186877/

Bubble-Induced Endothelial Microparticles Promote Endothelial Dysfunction

Yu X, Xu J, Huang G, et al. Bubble-Induced Endothelial Microparticles Promote Endothelial Dysfunction. Bader M, ed. PLoS ONE. 2017;12(1):e0168881. doi:10.1371/journal.pone.0168881.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256891/​

Warmers, Pumps & Filters

Amount of air infused to patient increases as fluid flow rates decrease when using the Hotline HL-90 fluid warmer.

Woon S, Talke P. Amount of air infused to patient increases as fluid flow rates decrease when using the Hotline HL-90 fluid warmer. J Clin Monit Comput. 1999 May;15(3-4):149-52.

http://www.ncbi.nlm.nih.gov/pubmed/12568165

Fluid warmer as a potential source of air bubble emboli.

Stevenson GW, Tobin M, Hall SC.  Fluid warmer as a potential source of air bubble emboli.  Anesth Analg.  1995 May; 80(5):1061.

http://www.ncbi.nlm.nih.gov/pubmed/7726413

A dangerous side of In-Line IV filters when used for vasoactive infusions in infants

Destiny Chau, D, Gish,B, Tzanetos, D, Zhang, C. A dangerous side of In-Line IV filters when used for vasoactive infusions in infants. J Anesth Safety Patient Foundation. 2013; 28(2).

http://www.apsf.org/newsletters/html/2013/fall/ltr04-inlineivfilters.htm

Potential for air embolism using Hotline™ model HL90 fluid warmer

Wolin, J, Vasdev, G. Potential for air embolism using Hotline™ model HL90 fluid warmer. J Clin. Anesth. 1996; 8(1):81-82.

http://www.sciencedirect.com/science/journal/09528180/8/1

Beware of Air in the Blood Pump

Breen, P, Hong, A. Beware of Air in the Blood Pump. Anesth Analg. 2000; 91(4):1038.

http://journals.lww.com/anesthesia-analgesia/Citation/2000/10000/Beware_of_Air_in_the_Blood_Pump.53.aspx

Intravenous Air: The Partially Invisible Phenomenon.

Varga C, Luria I, Gravenstein N. Intravenous Air: The Partially Invisible Phenomenon. Anesth Analg. 2016 Nov;123(5):1149-1155. PubMed PMID: 27749346.

https://www.ncbi.nlm.nih.gov/pubmed/27749346

Volume of Air Generated from HotlineⓇ Warmer – Plenty to Cause Serious Injury/Morbidity in Pediatrics

Haddad, I., Doucet, P., Lobozzo, J., Vadhera, A. Volume of Air Generated from HotlineⓇ Warmer – Plenty to Cause Serious Injury/Morbidity in Pediatrics.  ClearLine MD.  2016.

Case Reports

Air embolism--a case series and review.

Sviri S, Woods WP, van Heerden PV. Air embolism--a case series and review. Crit Care Resusc. 2004 Dec;6(4):271-6.

http://www.ncbi.nlm.nih.gov/pubmed/16556106

Air embolism--an analysis of 2000 incident reports.

Williamson JA, Webb RK, Russell WJ, Runciman WB. The Australian Incident Monitoring Study. Air embolism--an analysis of 2000 incident reports. Anaesth Intensive Care. 1993 Oct;21(5):638-41.

http://www.ncbi.nlm.nih.gov/pubmed/8273888

'Bubbles in the brain': systemic air embolism syndrome from an atrial-oesophageal fistula.

Cereda C, Staedler C, Moschovitis G, Caronni F, Bassetti CL, Azzola A. 'Bubbles in the brain': systemic air embolism syndrome from an atrial-oesophageal fistula. Emerg Med J. 2011 May;28(5):455. doi: 10.1136/emj.2010.093195.

http://www.ncbi.nlm.nih.gov/pubmed/20558494

Cerebral ischemia after venous air embolism in the absence of intracardiac defects.

Tommasino C, Rizzardi R, Beretta L, Venturino M, Piccoli S. Cerebral ischemia after venous air embolism in the absence of intracardiac defects. J Neurosurg Anesthesiol. 1996 Jan;8(1):30-4.

http://www.ncbi.nlm.nih.gov/pubmed/8719190

Air Embolism During Posterior Spinal Fusion in a 10-Year-Old Girl: A Case Report

Lee-Archer PF, Chaseling B. Air Embolism During Posterior Spinal Fusion in a 10-Year-Old Girl: A Case Report. A A Case Rep. 2017 Jun 1;8(11):307-309. doi: 10.1213/XAA.0000000000000498.

https://www.ncbi.nlm.nih.gov/pubmed/28328590

Pressurized Intravenous Fluid Administration in the Professional Football Player: A Unique Setting for Venous Air Embolism.

Fibel KH, Barnes RP, Kinderknecht JJ. Pressurized Intravenous Fluid Administration in the Professional Football Player: A Unique Setting for Venous Air Embolism. Clin J Sport Med. 2015 Jul;25(4):e67-9. Doi: 10.1097/JSM.0000000000000150.

http://www.ncbi.nlm.nih.gov/pubmed/25290105

Miscellaneous

Air bubble contact with endothelial cells causes a calcium-independent loss in mitochondrial membrane potential.

Sobolewski P, Kandel J, Eckmann DM. Air bubble contact with endothelial cells causes a calcium-independent loss in mitochondrial membrane potential. PLoS One. 2012;7(10):e47254. doi: 10.1371/journal.pone.0047254. Epub 2012 Oct 16. PubMed PMID: 23091614; PubMed Central PMCID: PMC3473031.

https://www.ncbi.nlm.nih.gov/pubmed/23091614

Air bubble contact with endothelial cells in vitro induces calcium influx and IP3-dependent release of calcium stores.

Sobolewski P, Kandel J, Klinger AL, Eckmann DM. Air bubble contact with endothelial cells in vitro induces calcium influx and IP3-dependent release of calcium stores. Am J Physiol Cell Physiol. 2011 Sep;301(3):C679-86. doi:10.1152/ajpcell.00046.2011. Epub 2011 Jun 1. PubMed PMID: 21633077; PubMed Central PMCID: PMC3273994.

https://www.ncbi.nlm.nih.gov/pubmed/21633077

Blog

Limitations and Failures of In-Line IV Filters

20 July 2017

A new study by ClearLineMD explores the limitations and failure points of commonly used in-line IV filters. The results are alarming. Clinical concerns include restrictions in flow rates, bolusing and back-siphoning effects.

Click here to download the study

© 2017

Congratulations Boston Children's Hospital - Ranked #1 Pediatric Hospital in the Nation

01 July 2017

Boston Children’s Hospital has been ranked the number one pediatric hospital in the nation by U.S. News & World Report’s 2017-18 Best Children’s Hospitals, for the 4th year in a row. Boston Children’s Hospital ranked in the top three in all 10 pediatric specialties.

ClearLine MD is proud to supply the ClearLine IV device in support of BCH’s mission of providing the highest quality care. Congratulations, Boston Children’s Hospital on a well deserved ranking and thank you for your unparalleled service to children.

ClearLine IV is the only FDA cleared and CE certified device that automatically detects and removes air from IV lines. Using state of the art, ultrasound sensing technology, ClearLine IV detects and removes air masses as small as 25 microliters and works with pumps, warmers, IV bag sets, IV solutions, blood and blood products.

© 2017

Scientific Presentation at IARS: Study Shows ClearLine IV™ System Reduces Intravascular Air During Rapid IV Fluid Bolus through a Hotline™ Fluid Warmer

30 May 2017

Findings from a study on the effectiveness of the ClearLine IV™ device were recently presented at the International Anesthesia Research Society (IARS) annual meeting held in Washington, D.C. in May 2017. The study utilized TEE imaging and optical densitometry to measure the amount of air in a patient’s heart following bolus administration of warm crystalloid fluid. The study found the ClearLine IV™ device effectively reduces the amount of air bubbles when delivering a warm solution at a fast rate. The study concluded that the ClearLine IV™ device reduces the risk of harmful and potentially fatal air emboli and can protect patients with patent foramen ovale (30-35% of the population) from paradoxical embolization.

Findings from the study will be published in the fall of 2017.

© 2017

National Nurses Week & National Hospital Week - Thank You Healthcare Professionals

10 May 2017

This week is National Nurses Week and National Hospital Week, and we at ClearLine MD applaud the hardworking, caring, and dedicated professionals on the front lines of patient care and patient safety.

Nurses are fundamental to health care and play a vital role in caring for patients through every step of the healthcare process; they go above and beyond their call of duty to ensure that every patient is cared for and receives the best treatment.

ClearLine MD gives gratitude to all hospital employees and clinicians, whom often face the most challenging of patient circumstances, and persevere giving their very best to achieve the best possible outcomes.

To all healthcare professionals, we salute you. Thank you for everything that you do.

© 2017

Latest CareFusion / BD Alaris Pump Recall is the 10th Class 1 Alaris Pump Recall Since 2010 by FDA

26 April 2017

FDA has assigned a Class 1 designation to a recall of CareFusion Alaris infusion pumps originally announced in January. This marks the 10th Class 1 recall of an Alaris device since 2010.

Infusion pumps have been one of the most recall-plagued medical devices in the past decade. From 2005 through 2009, FDA reviewed roughly 56,000 reports of adverse events linked to infusion pumps.

Class 1 recalls are reserved for situations “in which there is a reasonable probability the the use of or exposure to a violative product will cause adverse consequences or death.”

In this most recent recall CareFusion/BD recalled 350,000 Alaris infusion pumps for faulty air detection sensors. The recall warns “interruption of infusion could lead to serious adverse health consequences or death.” Of greatest concern, the faulty sensors may cause the pump to stop therapy to the patients.

© 2017

How Lucky Do You Feel When an Air Bubble Is In Your Intravenous Line? Part 3/3

20 April 2017

Air Mass in Bloodstream

By: Gerard J. Myers, RT, CCP Emeritus, Eastern Perfusion International

Part 3/3

Going back to the statement, that it would take a lot of air to cause you any harm makes you wonder how much air it would actually take to create a sudden, life threatening problem after the air went into the bloodstream.

Read More…

© 2017 Gerard Myers

How Lucky Do You Feel When an Air Bubble Is In Your Intravenous Line? Part 2/3

19 April 2017

Air Mass in Bloodstream

By: Gerard J. Myers, RT, CCP Emeritus, Eastern Perfusion International

Part 2/3

At birth, we are all born with an opening in the atrial wall of our heart that separates the right side of our heart and the left side of our heart. This opening is called a Foramen Ovale, and usually closes with our first few breaths at birth, sending venous blood to the lungs and arterial blood to the brain and the rest of the body.

Read More…

© 2017 Gerard Myers

How Lucky Do You Feel When an Air Bubble Is In Your Intravenous Line? Part 1/3

18 April 2017

Air Mass in Bloodstream

By: Gerard J. Myers, RT, CCP Emeritus, Eastern Perfusion International

Part 1 of 3

When was the last time you, or one of your loved ones, was in a hospital bed with an intravenous line attached to your arm and a bag of intravenous fluid hanging from an IV pole beside you? Perhaps when the bag of fluid began to empty, a health care worker entered the room to hang another bag of the lifesaving liquid, or maybe just attach a smaller bag of medication to run into you intravenous line.

Read More…

© 2017 Gerard Myers

Dangerous Amount of Air Emitted by Fluid Warmers

10 April 2017

A new study found a dangerous amount of air is emitted by fluid warmers - enough to cause serious clinical complications in pediatrics.

Read More…

© 2017

Celebrate National Patient Safety Awareness Week

15 March 2017

March 12 - 18 is Patient Safety Awareness Week, an initiative of the National Patient Safety Foundation that encourages everyone to Stand United for Patient Safety to reduce harm in patient care. #WEAREALLPATIENTS

Read More…

© 2017 ClearLine MD

Over 2.5 Million Infusion Pumps Recalled with Risk of Air Embolism

08 March 2017

Pumps are well known to have issues dealing with air in IV lines. Within the past 10 years, 2,549,871 pumps were included in recalls due to air-related accidents or incidents according to the FDA’s Maude database for adverse events.

Read More…

© 2017

Massive Recall Announced - Fluid Pumps Continue to Struggle with Air in Line

13 February 2017

Faulty Air-In-Line Sensor Leads to Recall of 349,746 Alaris Syringe Pumps

The FDA just announced a recall of nearly 350,000 Alaris Syringe Pumps for faulty air detection sensors. Of great concern, the faulty sensors may cause the pump to stop therapy infusion to the patient. Healthcare professionals may have to clear the alarm and restart the infusion. The FDA recall warns that “interruption of infusion could lead to serious adverse health consequences or death.”

Read More…

© 2017 ClearLine MD