What is the prognosis 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

The presence of gyriform air on CT scans of the brain appears to be a negative prognostic indicator in venous catheter-related cerebral air embolism. [35] Other potential predictors of unfavorable outcomes in patients with catheter-related VAE include older age of onset, an initial disturbance in consciousness, and the presence of hemparesis.

The potentially life-threatening and catastrophic consequences of VAE) are directly related to its effects on the affected organ system where the embolus lodges. VAE may be fatal and frequently carries high neurologic, respiratory, and cardiovascular morbidity. Catheter-associated VAE mortality is as high as 30%. [2]

In a case series of 61 patients with severe lung trauma, the mortality associated with concomitant VAE was 80% in the blunt trauma group and 48% in the penetrating trauma group. [10, 22, 34]  The morbidity and mortality associated with traumatic VAE, as with nontraumatic VAE, depends not only on associated injuries but also on the volume and rate of air entry, underlying cardiac condition, and the patient's position.

In a retrospective study of patients who were placed in a sitting position for neurosurgery, Ganslandt et al found a low rate of severe complications associated with VAE. In the study, 600 individuals underwent surgery for posterior fossa or cervical spinal disorders, with VAE occurring in 19% of these patients. However, only 3.3% of patients suffered severe VAE-associated complications, such as a drop in the partial pressure of oxygen or in blood pressure. Moreover, surgery had to be stopped in only three patients (0.5%) because the VAE could not be eliminated during surgery. No VAE-associated mortality occurred. [36]


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