Published online Sep 6, 2018. doi: 10.12998/wjcc.v6.i9.274
Peer-review started: April 2, 2018
First decision: May 8, 2018
Revised: May 31, 2018
Accepted: June 7, 2018
Article in press: June 8, 2018
Published online: September 6, 2018
Systemic air embolism through a bronchovenous fistula (BVF) has been described in patients undergoing positive-pressure ventilation. However, no report has mentioned the potential risks of systemic air embolism through a BVF in patients undergoing extracorporeal membrane oxygenation (ECMO). Positive-pressure ventilation and ECMO support in patients with lung injury can increase the risk of systemic air embolism through a BVF. Increased alveolar pressure, decreased pulmonary venous pressure, and anticoagulation are thought to be the factors that contribute to this complication. Here, we present a case of systemic air embolism in a patient with ECMO and mechanical ventilator support.
Core tip: Sudden deterioration of patients during extracorporeal membrane oxygenation support is not unusual. Usually, it is thought to result from the critical illness of the patients. This report suggests that some such cases may be related to bronchovenous fistula, which causes cerebral and coronary air embolisms.