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Critical Care Research and Practice
Volume 2011, Article ID 731758, 4 pages
http://dx.doi.org/10.1155/2011/731758
Case Report

Iatrogenic Hepatic Pneumovenogram

Department of Critical Care Medicine, Prince George's Hospital Center, 3001 Hospital Drive, 5th Floor, Cheverly, MD, 20785, USA

Received 7 November 2010; Accepted 20 March 2011

Academic Editor: Samuel A. Tisherman

Copyright © 2011 Govarthanan Rajendiran et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Accidental air entry during central venous catheterization is a preventable iatrogenic complication that can cause venous air embolism (VAE). Many cases of VAE are subclinical with no adverse outcome and thus go unreported. Usually, when symptoms are present, they are nonspecific, and a high index of clinical suspicion of possible VAE is required to prompt investigations and initiate appropriate therapy. Occasionally large embolism can lead to life-threatening acute cor pulmonale, asystole, sudden death, and arterial air embolism in the presence of shunt or patent foramen ovale. This paper discusses VAE during emergency central line placement and the diagnostic dilemma that it can be created in critically ill patients. All necessary precautions have to be strictly followed to prevent this iatrogenic complication.