What is the role of central venous catheterization in the etiology of venous air embolism (VAE)?

Updated: Dec 30, 2017
  • Author: Brenda L Natal, MD, MPH; Chief Editor: Erik D Schraga, MD  more...
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Answer

VAE is a potentially life-threatening and under-recognized complication of central venous catheterization (CVC), including central lines, pulmonary catheters, hemodialysis catheters [7, 13]  and Hickman (long-term) catheters. As mentioned earlier, the frequency of VAE associated with CVC use ranges from 1 in 47 to 1 in 3000. The emboli may occur at any point during line insertion, maintenance, and/or removal. [3]  A pressure gradient of 5 cm H2O between air and venous blood across a 14-gauge needle allows entry of air into the venous system at a rate of 100 mL/s. [1, 2, 11, 15, 21, 30]  Ingress of 300-500 mL of air at this rate can cause lethal effects. [15, 29]


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