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Systemic Gas Embolism Complicating Mechanical Ventilation in the Adult Respiratory Distress Syndrome
- John J. Marini, MD; and
- Bruce H. Culver, MD
Excerpt
Most forms of barotrauma related to mechanical ventilation are known to occur in both adult and pediatric patients. The pressure-driven transfer of gas from the alveolar compartment to the systemic circulation, a devastating complication of ventilatory support in infants, is not generally recognized as a consequence of ventilatory support in adults. Two young adult patients who received ventilatory support with high levels of positive pressure for pneumonia and the adult respiratory distress syndrome developed massive sub-pleural air cysts, interstitial emphysema, and tension pneumothoraces. Despite receiving appropriate treatment for these problems, the patients had recurrent episodes of cerebral infarction, myocardial injury,
Acknowledgments
Acknowledgments: The authors thank Dr. William O. Whetsell, Jr., and the neuropathology staff of Vanderbilt Hospital for technical assistance; and Brenda F. Plunkett and Michele E. Bundy for preparation of the manuscript.
Article and Author Information
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From the University of Minnesota, Minneapolis-St. Paul, Minnesota, and University of Washington, Seattle, Washington. For current author addresses, see end of text.
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Grant Support: Partial support by grants HL-07123 and HL-19153 from the National Heart, Lung, and Blood Institute and by the Ramsey Foundation.
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Requests for Reprints: John J. Marini, MD, Director of Pulmonary/Critical Care, St. Paul-Ramsey Medical Center, 640 Jackson Street, St. Paul, MN 55101-2595.
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Current Author Addresses: Dr. Marini, Department of Medicine, University of Minnesota, Minneapolis-St. Paul, MN 55101-2595.
Dr. Culver: Department of Medicine, University of Washington, Seattle, WA 98144.
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