Air embolism: diagnosis and management

Future Cardiol. 2017 Jul;13(4):365-378. doi: 10.2217/fca-2017-0015. Epub 2017 Jun 23.


Air embolism is an uncommon, but potentially life-threatening event for which prompt diagnosis and management can result in significantly improved patient outcomes. Most air emboli are iatrogenic. Arterial air emboli may occur as a complication from lung biopsy, arterial catheterization or cardiopulmonary bypass. Immediate management includes placing the patient on high-flow oxygen and in the right lateral decubitus position. Venous air emboli may occur during pressurized venous infusions, or catheter manipulation. Immediate management includes placement of the patient on high-flow oxygen and in the left lateral decubitus and/or Trendelenburg position. Hyperbaric oxygen therapy is the definitive treatment which may decrease the size of air emboli by facilitating gas reabsorption, while also improving tissue oxygenation and reducing ischemic reperfusion injury.

Keywords: air embolism; arterial air embolism; cardiac catheterization; cardiac imaging; complications; hyperbaric oxygen; iatrogenic; imaging; radiological approaches.

Publication types

  • Review

MeSH terms

  • Arteries
  • Biopsy / adverse effects
  • Cardiopulmonary Bypass / adverse effects
  • Catheterization / adverse effects
  • Embolism, Air / diagnosis*
  • Embolism, Air / diagnostic imaging
  • Embolism, Air / etiology
  • Embolism, Air / therapy*
  • Humans
  • Hyperbaric Oxygenation*
  • Infusions, Intravenous / adverse effects
  • Medical Illustration
  • Patient Positioning