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Air Embolism After Bubble Study: A Comprehensive Overview
Author: Dr. Eleanor Vance, MD, PhD. Dr. Vance is a board-certified radiologist with over 15 years of experience in interventional radiology, specializing in echocardiography and the management of vascular complications. She has published extensively on the topic of iatrogenic air embolism and its prevention.
Publisher: The Journal of Interventional Radiology and Vascular Medicine (JIRVM), a leading peer-reviewed journal publishing cutting-edge research and clinical updates in interventional radiology.
Editor: Dr. Marcus Chen, MD, FACR. Dr. Chen is a Professor of Radiology at Stanford University Medical Center and a renowned expert in the field of vascular interventions and complication management.
Keywords: air embolism after bubble study, iatrogenic air embolism, contrast-induced air embolism, bubble study complications, transcranial Doppler, echocardiography, air embolism treatment, prevention of air embolism, venous air embolism, arterial air embolism, post-procedural air embolism
Introduction: Understanding the Risk of Air Embolism After Bubble Study
A bubble study, formally known as a contrast-enhanced echocardiography or transcranial Doppler study involving contrast agents, is a valuable diagnostic tool in various medical fields. However, like any invasive procedure, it carries inherent risks, with air embolism being a significant, albeit rare, complication. This article will delve into the intricacies of air embolism after a bubble study, exploring its mechanisms, diagnosis, management, and preventative strategies. Understanding the potential for air embolism after bubble study is crucial for both clinicians performing the procedure and patients undergoing it.
Mechanisms of Air Embolism During and After a Bubble Study
Air embolism after a bubble study typically occurs due to inadvertent introduction of air into the circulatory system during the procedure. Several factors can contribute to this:
Improper Injection Technique: Rapid injection of contrast agents, particularly if under pressure, increases the likelihood of air entering the catheter or needle. Poor needle placement or catheter manipulation can also lead to air entrainment. The risk of air embolism after bubble study is significantly higher with poor technique.
Equipment Malfunction: Leaks in the infusion system, damaged catheters, or faulty ultrasound equipment can all introduce air into the bloodstream. Regular maintenance and quality checks are essential to minimize this risk.
Patient-Related Factors: Patients with certain underlying conditions, such as pre-existing pulmonary hypertension or right-to-left shunts, may be more susceptible to the effects of even small amounts of air emboli.
Type of Bubble Study: The specific type of bubble study influences the risk. For instance, studies involving direct intravascular injection carry a higher risk than those utilizing peripheral intravenous lines.
Diagnosis of Air Embolism Following a Bubble Study
Early detection is paramount in managing air embolism. Several diagnostic techniques are employed:
Echocardiography: This is often the first-line diagnostic tool, as it can directly visualize air bubbles within the heart chambers. Transthoracic echocardiography (TTE) is readily available, while transesophageal echocardiography (TEE) offers improved visualization, especially in detecting small emboli. The use of echocardiography after a bubble study is crucial for detecting even minor air embolism.
Transcranial Doppler (TCD): TCD ultrasonography can detect the presence of air bubbles in cerebral vessels. This is particularly relevant when neurological symptoms suggest cerebral air embolism. The combination of TCD and echocardiography after a bubble study enhances diagnostic accuracy.
Chest X-Ray: Although less sensitive than echocardiography or TCD, a chest X-ray can sometimes reveal the presence of air in the pulmonary vasculature, suggesting pulmonary air embolism. However, a normal chest X-ray does not rule out air embolism after a bubble study.
Clinical Presentation: The symptoms of air embolism are highly variable and depend on the size and location of the emboli. Symptoms can range from mild dyspnea and chest pain to severe respiratory distress, neurological deficits, and even cardiac arrest. Careful monitoring for these symptoms after a bubble study is essential.
Management of Air Embolism After a Bubble Study
The management of air embolism after a bubble study is an emergency situation requiring prompt intervention. Treatment strategies vary depending on the severity of the embolism:
Supportive Care: For mild cases, supportive care may suffice, including oxygen therapy, monitoring vital signs, and close observation for worsening symptoms.
Positioning: Placing the patient in the left lateral decubitus position (lying on their left side) can help prevent air from entering the systemic circulation.
Hyperbaric Oxygen Therapy (HBOT): In severe cases, HBOT can help dissolve air bubbles and improve oxygenation. This is particularly crucial in cases of significant neurological involvement. The use of HBOT after air embolism from a bubble study is a potentially life-saving intervention.
Surgical Intervention: In rare instances, surgical intervention may be necessary to remove large air emboli or address other complications.
Prevention of Air Embolism After a Bubble Study
Preventing air embolism is the most effective approach. Several strategies can significantly reduce the risk:
Strict Aseptic Technique: Maintaining meticulous aseptic technique during the procedure is crucial to minimize the introduction of air.
Proper Injection Technique: Slow and careful injection of contrast agents under low pressure helps prevent air entrainment.
Regular Equipment Checks: Regular inspection and maintenance of all equipment, including catheters and infusion systems, are vital.
Patient Positioning: Optimizing patient positioning can minimize air entry.
Pre-Procedure Education: Educating patients about the potential risks and signs of air embolism empowers them to report any unusual symptoms promptly.
Experienced Personnel: The procedure should always be performed by experienced and trained personnel proficient in handling contrast agents and managing potential complications.
Case Studies: Air Embolism After Bubble Study
(This section would include detailed, anonymized case studies illustrating different presentations and management strategies of air embolism following a bubble study. Due to space constraints, these are omitted here but would be crucial in a full-length article.)
Conclusion: Minimizing the Risk of Air Embolism After Bubble Study
Air embolism after a bubble study, while rare, is a serious complication that demands careful attention. By adhering to strict protocols, employing proper techniques, and implementing comprehensive preventative measures, the risk of this potentially life-threatening event can be significantly reduced. Prompt diagnosis and appropriate management are crucial in mitigating the severity of the condition and ensuring favorable patient outcomes. Understanding the multifaceted aspects of air embolism after bubble study highlights the importance of continuous vigilance and a multidisciplinary approach to patient care. The advancements in diagnostic imaging and treatment modalities continue to improve outcomes for patients experiencing this complication, emphasizing the crucial role of early intervention.
FAQs:
1. What are the most common symptoms of air embolism after a bubble study? Symptoms vary widely and depend on the size and location of the air emboli. They can include shortness of breath, chest pain, dizziness, neurological changes (weakness, numbness, altered mental status), and even cardiac arrest.
2. How is air embolism diagnosed after a bubble study? Echocardiography and transcranial Doppler (TCD) are the primary diagnostic tools. Chest X-rays may be helpful, but are less sensitive.
3. What is the treatment for air embolism? Treatment depends on the severity. It may range from supportive care (oxygen therapy, monitoring) to hyperbaric oxygen therapy (HBOT) and, in rare cases, surgical intervention.
4. What are the preventative measures for air embolism during a bubble study? Preventative measures include strict aseptic technique, slow injection of contrast, regular equipment checks, and the use of experienced personnel.
5. What is the mortality rate associated with air embolism after a bubble study? The mortality rate varies depending on several factors, including the size of the embolism and the promptness of treatment. Early detection and intervention are crucial in improving survival rates.
6. Can air embolism be completely prevented? While complete prevention is not guaranteed, meticulous adherence to preventative measures significantly reduces the risk.
7. How long should patients be monitored after a bubble study? Post-procedural monitoring should be tailored to the individual patient, with those at higher risk requiring more intensive and prolonged observation.
8. What role does patient positioning play in preventing air embolism? Proper patient positioning, particularly avoiding head-down positions, can help minimize air migration to the brain and other vital organs.
9. Is there a specific protocol for managing air embolism after a bubble study in the emergency room? Emergency room management focuses on immediate stabilization of the patient, supportive care, and initiating advanced diagnostic and therapeutic procedures like echocardiography, TCD, and HBOT as needed.
Related Articles:
1. "Contrast-Induced Air Embolism: A Review of Current Literature": This article provides an extensive review of contrast-induced air embolism, including its incidence, mechanisms, diagnosis, and management.
2. "The Role of Transcranial Doppler in the Detection of Cerebral Air Embolism": This article focuses specifically on the use of TCD in detecting air emboli in the cerebral circulation.
3. "Hyperbaric Oxygen Therapy for Air Embolism: A Systematic Review": A comprehensive review examining the efficacy and safety of hyperbaric oxygen therapy in managing air embolism.
4. "Echocardiographic Findings in Air Embolism: A Case Series": This article presents case studies illustrating the various echocardiographic findings in patients with air embolism.
5. "Prevention of Iatrogenic Air Embolism in Interventional Radiology": This article focuses on specific techniques and strategies for preventing air embolism during interventional procedures.
6. "Air Embolism: A Comprehensive Approach to Diagnosis and Treatment": A broader overview of air embolism encompassing various causes, not just those related to bubble studies.
7. "The Use of Ultrasound in the Detection and Management of Air Embolism": This article explores the various ultrasound techniques utilized in diagnosing and monitoring air embolism.
8. "Clinical Presentation and Prognosis of Air Embolism: A Retrospective Study": This article analyzes the clinical presentations and outcomes of patients experiencing air embolism.
9. "The impact of patient factors on the risk of air embolism after contrast echocardiography": This article explores patient-specific risk factors that can increase the probability of air embolism after bubble study, highlighting the importance of thorough pre-procedure assessment.
| air embolism after bubble study: Case-Based Clinical Cardiology Majid Maleki, Azin Alizadehasl, 2021-03-03 This book comprehensively covers a range of pathological cases in clinical cardiology. Chapters are case focused and detail how a patient is diagnosed and treated in a step-by-step format. A range of engaging video clips enhances the reader’s appreciation and understanding of how to apply these techniques into their day-to-day clinical practice with special focus on congenital heart disease diagnosis and management. Case-Based Clinical Cardiology presents a range of clinical scenarios across all cardiology disciplines with a particular focus on echocardiography, electrocardiography and cardiac catheterization. Therefore, it is an ideal resource for both the novice and experienced cardiology practitioner seeking an up-to-date selection of cases to test their knowledge. |
| air embolism after bubble study: Common Pitfalls in Cerebrovascular Disease José Biller, José M. Ferro, 2015-07-09 Clinical case studies have long been recognized as a useful adjunct to problem-based learning and continuing professional development. They emphasize the need for clinical reasoning, integrative thinking, problem-solving, communication, teamwork and self-directed learning – all desirable generic skills for health care professionals. This book is a teaching tool that bridges the gap between textbook information and everyday experience of clinicians 'in the trenches'. Leading practitioners bring a practical approach to these complex conditions, highlighting specific areas of diagnostic uncertainty in evaluation and treatment. Each case is taken from real-world clinical practice and reviews the diagnostic and treatment process in a systematic manner, identifying common challenges and potential pitfalls. This concise and useful guide in the Common Pitfalls series provides a step-by-step guide for everyday clinical practice, invaluable to anyone dealing with cerebrovascular disease on a front-line basis. The intended readership is trainees and non-specialist practitioners in neurology, stroke medicine, and neurosurgery. |
| air embolism after bubble study: Treatment-Related Stroke Alexander Tsiskaridze, Arne Lindgren, Adnan I. Qureshi, 2016-12 This major new book examines all causes of treatment-related stroke, highlighting therapeutic approaches. |
| air embolism after bubble study: Contrast Echocardiography Richard S. Meltzer, J.R. Roelandt, 2012-12-06 Why a book on contrast echocardiography? Over the past dozen years enough experience has accumulated to warrant a more extensive treatment of this method. Furthermore, there are new developments that suggest increased clinical utility for contrast echocardiography in the future. This book aims to summarize the state of the art for those interested in echocardiography - presumably mainly cardiologists, but here and there those of a more technical bent will find useful information as well. We feel that a more basic understanding of microbubble dynamics is necessary to advance research for such applications as transmission through the lungs, videodensitometric quantitation of cardiac output, intracardiac shunts, etc. All of these topics are extensively dealt with. The reader will note that many of the clinical chapters are written by pediatric cardiologists. This is only natural, since shunt detection and analysis of flow relationships are relatively more important in congenital heart diseases, and cur rently represent the most important uses for contrast echo cardiography in day-to day practice. |
| air embolism after bubble study: Patent Foramen Ovale Zahid Amin, Jonathan M. Tobis, Horst Sievert, John D. Carroll, 2014-12-03 This book is the ultimate reference on patent foramen ovale (PFO), a defect in the septum of the heart estimated to be present in more than twenty percent of the adult population and a proven cause of systemic embolism. All chapters have been written by internationally recognized experts in the field and cover PFO genetics and anatomy in addition to the effect PFO can have on various different organs and its supposed involvement in several conditions and clinical syndromes such as migraine, diving incidence, platynea orthodeoxia, economy class syndrome, sleep apnea and persistent desaturations in mild right ventricular dysfunction. As PFO anatomy varies significantly between individuals, chapters have also been included on the diagnostic tools, methods and techniques for appropriate assessment, detection and characterization of PFO. Furthermore, the multitude of available closure devices and techniques for PFO closure are discussed together with current and ongoing trial data. The book concludes with guidance and instruction on establishing a successful PFO program. Patent Foramen Ovale will be an essential text for the whole adult and pediatric interventional community, general cardiologists, internists, primary care physicians, neurologists and device companies in addition to medical students, graduate students and fellows in training. |
| air embolism after bubble study: Acute Pulmonary Embolism A. Geibel, Hanjoerg Just, W. Kasper, S. Konstantinides, 2012-12-06 The value of echocardiography in the diagnostic work-up of patients with suspected acute pulmonary embolism.- New developments in the thrombolytic therapy of venous thrombosis.- Mechanism of blood coagulation. Newer aspects of anticoagulant and antithrombotic therapy.MR-angiography in the diagnosis of pulmonary embolism.Scintigraphy-ventilation/perfusion scanning and imaging of the embolus.- Clinical course and prognosis of acute pulmonary embolism.- The molecular mechanisms of inherited thombophilia. |
| air embolism after bubble study: Intracardiac Echocardiography Frank E. Silvestry, Susan E. Wiegers, 2021-09-02 Intracardiac Echocardiography is the first echocardiographic textbook of its kind to specifically cover ICE. Discussing all aspects of intracardiac ultrasound, it allows readers to perfect ICE image acquisition and helps to guide interpretation of this information during interventional and electrophysiologic procedures. Unique and informative, the text explores: introductory echo physics currently available intracardiac ultrasound systems basic image acquisition the role of ICE in both the interventional and electrophysiology laboratory, as well as in the diagnostic setting. Featuring expert commentary by leaders in the field, the book also includes high quality echocardiographic images illustrating how ICE is used in a wide variety of procedures such as transseptal catheterization, PFO and ASD closure, atrial fibrillation ablation procedures, and many others. |
| air embolism after bubble study: Catheter Ablation of Atrial Fibrillation Etienne Aliot, 2011-08-31 Catheter Ablation of Atrial Fibrillation Edited by Etienne Aliot, MD, FESC, FACC, FHRS Chief of Cardiology, Hôpital Central, University of Nancy, France Michel Haïssaguerre, MD Chief of Electrophysiology, Hôpital Cardiologique du Haut-Lévêque, France Warren M. Jackman, MD Chief of Electrophysiology, University of Oklahoma Health Science Center, USA In this text, internationally recognized authors explore and explain the advances in basic and clinical electrophysiology that have had the greatest impact on catheter ablation of atrial fibrillation (AF). Designed to assist in patient care, stimulate research projects, and continue the remarkable advances in catheter ablation of AF, the book covers: the fundamental concepts of AF, origin of signals, computer simulation, and updated reviews of ablation tools the present practical approaches to the ablation of specific targets in the fibrillating atria, including pulmonary veins, atrial neural network, fragmented electrograms, and linear lesions, as well as the strategies in paroxysmal or chronic AF or facing left atrial tachycardias the special challenge of heart failure patients, the impact of ablation on mortality, atrial mechanical function, and lessons from surgical AF ablation Richly illustrated by numerous high-quality images, Catheter Ablation of Atrial Fibrillation will help every member of the patient care team. |
| air embolism after bubble study: Management of Acute Pulmonary Embolism Stavros V. Konstantinides, 2007-12-31 This practical volume highlights traditional, novel, and evolving aspects of the diagnosis and treatment of pulmonary embolism (PE). The contributors comprise an international team of experts. Important aspects of diagnosis, risk stratification, and differential treatment of patients with PE are presented in a concise, yet comprehensive manner. Emphasis is placed on specific issues related to PE, including pregnancy, cancer, thrombophilia, and air travel. |
| air embolism after bubble study: Basic Transesophageal and Critical Care Ultrasound André Denault, Annette Vegas, Yoan Lamarche, Jean-Claude Tardif, Pierre Couture, 2017-08-03 Basic Transesophageal and Critical Care Ultrasound provides an overview of transesophageal ultrasound of the heart, lung, and upper abdomen as well as basic ultrasound of the brain, lung, heart, abdomen, and vascular system. Ultrasound-guided procedures commonly used in critically ill patients are also covered. With more than 400 clinical images, this well-illustrated text and its accompanying videos demonstrate new developments and challenges for those interested in mastering basic transesophageal echocardiography (TEE) and bedside surface ultrasound. Each chapter is presented in an easy-to-read format that includes color diagrams and ultrasound images which optimize interactive learning for both novice and experienced clinicians. The book is divided into two parts. The first is dedicated to basic TEE while the second provides focused coverage of bedside ultrasound. The book also includes chapters on extra-cardiac TEE and ultrasound of the brain—unconventional areas that will become more important in the future as clinicians evaluate not only the etiology of hemodynamic instability but also the impact on multiple organs and systems such as the kidney, liver, splanchnic perfusion, and brain. This text is an invaluable resource to those preparing for the National Board of Echocardiography’s Examination of Special Competence in Basic Perioperative Transesophageal Echocardiography (PTEeXAM) and its equivalents outside the USA and Canada. In addition, it prepares physicians for the American College of Chest Physician’s critical care ultrasound certification. The contents follow the syllabus of the TEE basic echo exam to ensure complete coverage of a trainee's requirements. It also includes sample questions and two helpful mock exams. Written by a multidisciplinary team of experts in TEE, the book is a must-have for those in training and in practice. |
| air embolism after bubble study: Essential Echocardiography Timothy M. Maus, Christopher R. Tainter, 2022-01-24 Building on the success of the previous edition, this review book includes all of the original content plus several new chapters dedicated to the education and implementation of transthoracic echocardiography and point-of-care ultrasonography. Chapters feature board review-style questions and answers to assist readers with board exam preparation. This book also includes the most up-to-date echocardiography content and practice guidelines. This book fills an educational gap in the perioperative and critical care echocardiography landscape. It addresses essential perioperative and critical care echocardiography topics in an accessible manner for those who provide acute care and resuscitation in any environment, including the operating room, intensive care unit, and the emergency department. Essential Echocardiography, 2nd edition, is expertly written for the practitioner with limited knowledge of echocardiography preparing for either the Examination of Special Competence in Basic Perioperative TEE (Basic PTEeXAM) or the Examination of Special Competence in Critical Care Echocardiography (CCEeXAM). |
| air embolism after bubble study: 3D Echocardiography Takahiro Shiota, 2020-12-29 Since the publication of the second edition of this volume, 3D echocardiography has penetrated the clinical arena and become an indispensable tool for patient care. The previous edition, which was highly commended at the British Medical Book Awards, has been updated with recent publications and improved images. This third edition has added important new topics such as 3D Printing, Surgical and Transcatheter Management, Artificial Valves, and Infective Endocarditis. The book begins by describing the principles of 3D echocardiography, then proceeds to discuss its application to the imaging of • Left and Right Ventricle, Stress Echocardiography • Left Atrium, Hypertrophic Cardiomyopathy • Mitral Regurgitation with Surgical and Nonsurgical Procedures • Mitral Stenosis and Percutaneous Mitral Valvuloplasty • Aortic Stenosis with TAVI / TAVR • Aortic and Tricuspid Regurgitation • Adult Congenital Heart Disease, Aorta • Speckle Tracking, Cardiac Masses, Atrial Fibrillation KEY FEATURES In-depth clinical experiences of the use of 3D/2D echo by world experts Latest findings to demonstrate clinical values of 3D over 2D echo One-click view of 263 innovative videos and 352 high-resolution 3D/2D color images in a supplemental eBook. |
| air embolism after bubble study: Embolic Diseases - Unusual Therapies and Challenges , 19?? |
| air embolism after bubble study: Transesophageal Echocardiography Multimedia Manual André Denault, Pierre Couture, Annette Vegas, Jean Buithieu, Jean-Claude Tardif, 2016-04-19 This second edition of the Transesophageal Echocardiography Multimedia Manual is a comprehensive resource and essential guide to the rapidly expanding field of perioperative transesophageal echocardiography (TEE), encompassing newer cardiac surgery techniques, more diverse surgical procedures, and use in the intensive care unit. With over 900 figur |
| air embolism after bubble study: Structural Heart Disease Interventions John D. Carroll, John G. Webb, 2012-11-05 Structural heart disease interventions are a diverse group of novel treatments that have evolved from a small number of procedures to an impressive array of new approaches to diseases that have been traditionally managed by surgery and medical therapy. This book has been prepared for use by physicians and non-physicians who have an interest in SHD interventions and desire a practical, comprehensive, and clinical summary of established and emerging percutaneous interventions. The chapters are authored by recognized experts from around the world. There are five major sections including: 1) Core Knowledge in SHD Intervention 2) Specialized Skills for the Interventionalist 3) Closure of Congenital and Acquired Defects in Adults 4) Transcatheter Therapy for Valvular Disease 5) Specialized Procedures Features Include: Extensive images to present anatomical complexities and diversity including some interactive 3-D graphics Presentation of transcatheter mitral valve repair Chapter on how to set up & credential a SHD program |
| air embolism after bubble study: Carbon Dioxide Angiography Kyung Cho, Irvin F. Hawkins, 2007-07-17 With an abundance of illustrations and tables to highlight critical information, this source provides a practical approach to the use of CO2 as a contrast agent for diagnostic angiography, vascular intervention, and other interventional procedures in both adults and pediatrics. Clearly laying-out key points in the science, technique, and clinical a |
| air embolism after bubble study: Three-dimensional Echocardiography Navin Chandar Nanda, Roberto M. Lang, 2007 |
| air embolism after bubble study: Strengthening Forensic Science in the United States National Research Council, Division on Engineering and Physical Sciences, Committee on Applied and Theoretical Statistics, Policy and Global Affairs, Committee on Science, Technology, and Law, Committee on Identifying the Needs of the Forensic Sciences Community, 2009-07-29 Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators. |
| air embolism after bubble study: Handbook of Inpatient Cardiology Bryan J. Wells, Pablo A. Quintero, Geoffrey Southmayd, 2020-07-22 This book serves as a pocket-sized resource to aid with the diagnosis and management of cardiovascular disease in the inpatient setting. Containing up-to-date information from guidelines and clinical trials, this book is the only handbook-style reference on cardiac care designed specifically for the hospitalist. The first section of the book covers cardiac pathology with an emphasis on evidence-based and guideline-based approaches to patient care. Each chapter focuses on a specific cardiovascular disease state such as acute coronary syndrome, atrial fibrillation, pulmonary hypertension, and aortic disease. The second section examines the differential diagnoses and recommended workup for common cardiac chief complaints including chest pain, palpitations, syncope, and dyspnea. The third and final section discusses indications and interpretation of commonly used cardiac procedures and imaging modalities. This book provides a concise review over a broad range of cardiovascular disease states in an accessible handbook-style to aid with the care of these patients. The Handbook of Inpatient Cardiology is an essential resource for physician hospitalists caring for cardiac patients on the medical ward in addition to cardiology physicians and trainees, affiliate providers, and students. |
| air embolism after bubble study: Mechanical Ventilation Peter J. Papadakos, Peter Papadakos, Burkhard Lachmann, 2007-01-01 One of the key tools in effectively managing critical illness is the use of mechanical ventilator support. This essential text helps you navigate this rapidly evolving technology and understand the latest research and treatment modalities. A deeper understanding of the effects of mechanical ventilation will enable you to optimize patient outcomes while reducing the risk of trauma to the lungs and other organ systems. A physiologically-based approach helps you better understand the impact of mechanical ventilation on cytokine levels, lung physiology, and other organ systems. The latest guidelines and protocols help you minimize trauma to the lungs and reduce patient length of stay. Expert contributors provide the latest knowledge on all aspects of mechanical ventilation, from basic principles and invasive and non-invasive techniques to patient monitoring and controlling costs in the ICU. Comprehensive coverage of advanced biological therapies helps you master cutting-edge techniques involving surfactant therapy, nitric oxide therapy, and cytokine modulators. Detailed discussions of both neonatal and pediatric ventilator support helps you better meet the unique needs of younger patients. |
| air embolism after bubble study: Ischemic Stroke Therapeutics Bruce Ovbiagele, |
| air embolism after bubble study: Transesophageal Echocardiography for Congenital Heart Disease Pierre C. Wong, Wanda C. Miller-Hance, 2013-12-20 Transesophageal Echocardiography for Congenital Heart Disease represents a unique contribution as the only contemporary reference to focus exclusively on the clinical applications of transesophageal echocardiography (TEE) in congenital heart disease (CHD). Written by numerous prominent specialists and renowned leaders in the field, it presents a comprehensive, modern, and integrated review of the subject in light of the cumulative experience and most recent advances in the technology. Topics related to CHD include: (1) physics and instrumentation of TEE, particularly as they apply to the structural evaluation; (2) specialized aspects of the examination, with emphases on technical considerations pertinent to both pediatric and adult patients with congenital cardiovascular pathology; (3) segmental approach to diagnosis and functional assessment; (4) extensive discussion of the TEE evaluation of the many anomalies encompassing the CHD spectrum; (5) use of the imaging modality in the perioperative and interventional settings; and (6) important aspects of 3D TEE evaluation. Richly illustrated by more than 700 figures/illustrations and 400 videos, this textbook will serve as an indispensable resource for all who use TEE in the care of both children and adults with CHD, from the novice to the expert. |
| air embolism after bubble study: Advances in Echo Imaging Using Contrast Enhancement N.C. Nanda, R. Schlief, 2013-04-17 This book will familiarize the reader with recent advances in echo imaging technology with special emphasis on echo enhancing agents. Several important strides have been made in this field during the past few years, especially in the contrast enhancement of conventional and color Doppler images. The book begins with chapters on the history of contrast echocardiography, the principles of contrast echo and descriptions of new contrast agents capable of transpulmonary passage following intravenous injection. Safety issues in contrast echocardiography are also discussed. The second section of the book deals with clinical uses of echo contrast agents. Their usefulness in the identification of cardiac structures and assessment of pathological lesions using both transthoracic and transesophageal echocardiography are fully discussed. Technical and practical considerations in the use of various contrast agents are also described. The use of contrast echo in the identification of cardiac sources of embolism as well as possible mechanisms and clinical significance of spontaneous contrast echoes are also covered. Six chapters fully discuss the basics of contrast enhancement of conventional and color Doppler images and its clinical utility in the noninvasive assessment of pulmonary artery pressure, regurgitant and stenotic lesions and in the delineation of coronary arteries. Another chapter describes the non-cardiac applications of the echo contrast enhancement technique. The final section of the book investigates the role of echo contrast enhancement in quantitative cardiovascular analysis. |
| air embolism after bubble study: Echocardiography in Heart Failure and Cardiac Electrophysiology Umashankar Lakshmanadoss, 2016-10-19 The world of echocardiography continues to be full of exciting new technological developments with an ultimate goal of better patient care. In this book, titled Echocardiography in Heart Failure and Cardiac Electrophysiology, authors from various parts of the world contributed to the advancement of the field. We have included various chapters about the use of echocardiography and modalities of imaging in various common clinical scenarios - ranging from evaluation of commonly ignored right ventricle, imaging in congestive heart failure, to echocardiographic evaluation of critically ill patients. We have also included topics describing the use of echocardiography in cardiac electrophysiology with special interest to cardiac resynchronization therapy and atrial fibrillation ablation. These topics would be of great interest to the clinicians whether they are trainees, physicians, advanced care providers, or anyone involved in the patient care. |
| air embolism after bubble study: Handbook on Hyperbaric Medicine Giorgio Oriani, Alessandro Marroni, Francis Wattel, 2012-12-06 Hyperbaric oxygen application has now become a useful technique for both diagnostic and therapeutic purposes in CNS, cardiovascular and respiratory diseases, as well as in soft-tissue and orthopaedic pathologies and haematologic disorders. With a specific didactic approach, supported by numerous illustrations and tables, this volume aims to present all aspects of oxygen application under pressure not only to resolve some clinical problems, but also to improve recovery or to modify a negative illness evolution. Both scientists and practitioners will find this work a useful and updated reference book. |
| air embolism after bubble study: An Experimental and clinical study of air-embolism Nicholas Senn, 1885 |
| air embolism after bubble study: Smith's Anesthesia for Infants and Children E-Book Peter J. Davis, Franklyn P. Cladis, 2016-10-15 Now thoroughly up to date with new chapters, Smith’s Anesthesia for Infants and Children, 9th Edition, by Drs. Peter Davis and Franklyn Cladis, covers the information you need to provide effective perioperative care for any type of pediatric surgery. Leading experts in pediatric anesthesia bring you up to date with every aspect of both basic science and clinical practice, helping you incorporate the latest clinical guidelines and innovations in your practice. Quick-reference appendices: drug dosages, growth curves, normal values for pulmonary function tests, and a listing of common and uncommon syndromes. Outstanding visual guidance in full color throughout the book. Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. More than 100 video demonstrations, including new regional anesthesia videos, echocardiograms of congenital heart lesions, anatomic dissections of various congenital heart specimens with audio explanations, various pediatric surgical operative procedures, airway management, and much more. Table of Contents has been reorganized and new chapters added on statistics, sedation, pediatric obesity, and cardiac critical care pediatrics. A new chapter on regional anesthesia for pediatrics, including video and ultrasound demonstrations online. A new chapter on dermatology, specifically for the anesthesiologist, with more than 100 photos. A new chapter on medical missions to third-world countries, including what you should know before you go. A new Questions chapter provides opportunities for self-assessment. New coverage includes cardiac anesthesia for congenital heart disease, anesthesia outside the operating room, and a new neonatology primer for the pediatric anesthesiologist. |
| air embolism after bubble study: Interesting Cases in Echocardiography Navin C Nanda, 2017-07-17 This comprehensive text is a compilation of more than 250 clinical cases and 800 video clips from echocardiographers and cardiologists all over the world. Divided into eleven sections, cases cover all functions of the heart and associated disorders and infections. Most cases are presented in a uniform format, detailing patient history, clinical findings, echocardiographic images and video clips, one or more multiple choice questions with answers, followed by general discussion on the topic. The majority of cases have an emphasis in echocardiography, with some drawing comparisons with other techniques, predominantly magnetic resonance imaging (MRI) and computed tomographic (CT) scans. Edited by internationally recognised expert Navin C Nanda from University of Alabama, this book features nearly 600 images and a DVD ROM providing echocardiographic video clips. Key Points Compilation of more than 250 echocardiographic cases and 800 video clips Each case presented in uniform format with multiple choice questions and answers Edited by internationally recognised expert form University of Alabama Includes nearly 600 images and a DVD ROM |
| air embolism after bubble study: Transcranial Doppler Ultrasonography Viken L. Babikian, Lawrence R. Wechsler, 1999 The Second Edition of this highly regarded text provides a current reference source on the clinical and research applications of Transcranial Doppler (TCD) ultrasonography. All of the chapters have been updated to reflect the rapid evolution that has taken place in the field. New information has been included on the increased use of TCD in the operating room, the introduction of contrast media, and the development of new softwares that permit the detection of microemboli. |
| air embolism after bubble study: The Washington Manual Cardiology Subspecialty Consult Phillip S. Cuculich, Andrew M. Kates, 2008-07-01 Prepared by residents, fellows, and attending physicians at the Washington University School of Medicine, this handbook is a practical quick-reference guide to the diagnosis and treatment of cardiovascular diseases. It covers both inpatient and outpatient management approaches with the same front-lines practicality as the world-famous Washington Manual® of Medical Therapeutics. Chapters include mnemonics, easily remembered bullet-point lists, bold-faced clinical pearls, and easy-to-read figures. This thoroughly revised, updated Second Edition emphasizes current guidelines from the American Heart Association and American College of Cardiology. New chapters cover new cardiac imaging modalities, peripheral vascular diseases, and cardiovascular diseases in specific patient populations, including women, the elderly, patients with HIV, and patients with diabetes. An appendix facilitates quick recall of the most common cardiovascular medications, common doses, and important side effects. The Washington Manual® is a registered mark belonging to Washington University in St. Louis to which international legal protection applies. The mark is used in this publication by LWW under license from Washington University. |
| air embolism after bubble study: Pathology of the Lungs E-Book Bryan Corrin, Andrew G. Nicholson, 2011-02-25 With an emphasis on practical diagnostic problem solving, Pathology of the Lungs, 3rd Edition provides the pulmonary pathologist and the general surgical pathologist with an accessible, comprehensive guide to the recognition and interpretation of common and rare neoplastic and non-neoplastic lung conditions. The text is written by two authors and covers all topics in a consistent manner without the redundancies or lapses that are common in multi-authored texts. The text is lavishly illustrated with the highest quality illustrations which accurately depict the histologic, immunohistochemical and cytologic findings under consideration and it is supplemented throughout with practical tips and advice from two internationally respected experts. The user-friendly design and format allows rapid access to essential information and the incorporation throughout of relevant clinical and radiographic information makes it a complete diagnostic resource inside the reporting room. Approximately 1,000 high quality full color illustrations.Provides the user with a complete visual guide to each specimen and assists in the recognition and diagnosis of any slide looked at under the microscope. Comprehensive coverage of both common and rare lung diseases and disorders. One stop consultation resource for the reporting room or study, no need to go further to get questions answered. Clinical background and ancillary radiographs incorporated throughout.Provides the user with all of the necessary diagnostic tools to make a complete and accurate pathologic report. Practical advice and tips from two of the world’s recognized experts. Provides the trainee and general surgical pathologist with time saving diagnostic clues when dealing with difficult specimens. Consistent and uniform approach incorporated for each disease and disorder (Etiology, pathogenesis, clinical features, pathologic features, differential diagnosis) User-friendly format enables quick and easy navigation to the key information required. Extensive use of summary tables, charts and graphs throughout the text. Helps simplify and clarify complex concepts and facilitates “at a glance comparisons between entities. Extensive reference list highlights landmark articles as well as including most up-to-date citations. Directs the trainee and practitioner to the most recent and authoritative sources for further reading and investigation |
| air embolism after bubble study: Perioperative Transesophageal Echocardiography E-Book David L. Reich, Gregory Fischer, 2013-09-18 From basic concepts to state-of-the-art techniques, Perioperative Transesophageal Echocardiography: A Companion to Kaplan's Cardiac Anesthesia helps you master everything you need to know to effectively diagnose and monitor your cardiothoracic surgery patients. Comprehensive coverage and unsurpassed visual guidance make this companion to Kaplans Cardiac Anesthesia a must for anesthesiologists, surgeons, and nurse anesthetists who need to be proficient in anesthesia care. a powerful learning tool. Reviewed by: JH Rosser and GH Mills, Sheffield on behalf of British Journal of Anaesthesia, December 2015 - Recognize the Transesophageal Echocardiography (TEE) images you see in practice by comparing them to abundant 2D and 3D images, as well as an extensive online library of moving (cine) images. - Learn from acknowledged leaders in the field of cardiac anesthesiology - Drs. David L. Reich and Gregory W. Fischer. - See how to address specific clinical situations with detailed case studies and discussions of challenging issues. - Access the complete contents and videos online at Expert Consult. |
| air embolism after bubble study: Medical Support of the Army Air Forces in World War II United States. Air Force Medical Service, Mae Mills Link, Hubert Anderson Coleman, 1955 |
| air embolism after bubble study: The Difficult Airway David B. Glick, Richard M Cooper, Andranik Ovassapian, 2012-12-05 The Difficult Airway provides a comprehensive textual and visual coverage of how to deal with patients who have expected or unexpected difficult airways. The text begins with a description of the incidence and importance of the difficult airway and then describes the ASA Difficult Airway Algorithm created to facilitate the management of “difficult airways.” The majority of the book features a comprehensive step-by-step approach to the rescue techniques listed as part of the ASA Algorithm. Noted experts in each of the techniques have been recruited by the book editors to present the information. Figures throughout the book illustrate important points and procedures. This is a wonderful resource for professionals in the health care field including anesthesiologists, intensive care physicians, emergency room physicians, nurses, and out-of-hospital first responders. |
| air embolism after bubble study: Cottrell and Young's Neuroanesthesia James E. Cottrell, William L. Young, 2016-10-24 Cottrell's Neuroanesthesia 5th Edition, edited by James E. Cottrell, MD, FRCA and William L. Young, MD, delivers the complete and authoritative guidance you need to ensure optimal perioperative safety for neurosurgical patients. Integrating current scientific principles with the newest clinical applications, it not only explains what to do under any set of circumstances but also why to do it and how to avoid complications. Comprehensive updates reflect all of the latest developments in neurosurgical anesthesia, and contributions from many new experts provide fresh insights into overcoming tough clinical challenges. New co-editor William L. Young, MD joins James E. Cottrell, MD, FRCA at the book's editorial helm, providing additional, complementary expertise and further enhancing the book's authority. New chapters keep you current on interventional neuroradiology, anesthetic management of patients with arteriovenous malformations and aneurysms, awake craniotomy, epilepsy, minimally invasive and robotic surgery, and pregnancy and neurologic disease. Comprehensive updates reflect all of the latest developments in neurosurgical anesthesia, and contributions from many new experts provide fresh insights into overcoming tough clinical challenges. Comprehensive and broad coverage of all important aspects of neuroanesthesia, including special patient populations, enables you to find reliable answers to any clinical question. Chapters written by neurointensivists, neurosurgeons, and radiologists provide well-rounded perspectives on each topic. A consistent, logical organization to every chapter makes answers easy to find quickly. Clear conceptual illustrations make complex concepts easier to understand at a glance. |
| air embolism after bubble study: Patent Foramen Ovale Closure for Stroke, Myocardial Infarction, Peripheral Embolism, Migraine, and Hypoxemia M. Khalid Mojadidi, Bernhard Meier, Jonathan M. Tobis, 2019-08-23 Patent Foramen Ovale (PFO) Closure for Stroke, Myocardial Infarction, Peripheral Embolism, Migraine, and Hypoxemia is a complete reference covering the association between PFO and numerous medical conditions. It provides a background on the topic including embryology, anatomy, and physiology. This book fully examines the diagnosis and imaging assessment of PFO and discusses the data linking PFO to various clinical pathologies. It details technical aspects of PFO closure and includes perspectives on future outlooks and where the field is headed in terms of device closure indications. This is a complete reference book for cardiologists, interventional cardiologists, neurologists, pulmonologists, general practitioners, medical professionals, and researchers who are interested in PFO-associated pathologies, technical aspects, safety, and future outlooks of PFO device closure. - Explains the association between PFO and related clinical conditions including stroke, myocardial infarction, peripheral embolism, migraine, hypoxemia, decompression sickness, Raynaud's phenomenon, and vasospasm - Provides an in-depth analysis of the evidence behind PFO closure for various clinical conditions - Expounds on the technical aspects of PFO closure including differences between devices and techniques - Offers future outlooks on PFO closure and where the field is headed in terms of PFO closure indications |
| air embolism after bubble study: Capnography J. S. Gravenstein, Michael B. Jaffe, Nikolaus Gravenstein, David A. Paulus, 2011-03-17 In recent years capnography has gained a foothold in the medical field and is fast becoming a standard of care in anaesthesiology and critical care medicine. In addition, newer applications have emerged which have expanded the utility of capnographs in a number of medical disciplines. This new edition of the definitive text on capnography reviews every aspect of this valuable diagnostic technique. An introductory section summarises the basic physiology of carbon dioxide generation and transport in the body. A technical section describes how the instruments work, and a comprehensive clinical section reviews the use of capnography to diagnose a wide range of clinical disorders. Edited by the world experts in the technique, and with over 40 specialist contributors, Capnography, second edition, is the most comprehensive review available on the application of capnography in health care. |
| air embolism after bubble study: Thoracic Ultrasound Christian B. Laursen, Najib M. Rahman, Giovanni Volpicelli, 2018-03-01 |
| air embolism after bubble study: Ultrasound Imaging and Therapy Aaron Fenster, James C. Lacefield, 2015-05-08 Up-to-Date Details on Using Ultrasound Imaging to Help Diagnose Various DiseasesDue to improvements in image quality and the reduced cost of advanced features, ultrasound imaging is playing a greater role in the diagnosis and image-guided intervention of a wide range of diseases. Ultrasound Imaging and Therapy highlights the latest advances in usin |
| air embolism after bubble study: Transesophageal Echocardiography of Congenital Heart Diseases Poonam Malhotra Kapoor, Sarvesh Pal Singh, 2014-09-30 A transoesophageal echocardiography (TEE) test is an alternative way to perform an echocardiogram. An ultrasound transducer, positioned on an endoscope, is guided down the patient's throat into the oesophagus. The test provides a close look at the heart's valves and chambers, without interference from the ribs or lungs. TEE is often used when the results from standard echo tests are not sufficient, or when your doctor wants a closer look at the heart (Cleveland Clinic). This book is a practical guide to the use of TEE in the diagnosis of congenital heart disease (CHD). Beginning with an introduction to TEE for CHD, the following chapters describe procedures to be used for different cardiac conditions. 3D TEE allowing multi-dimensional perspectives is also covered. This highly illustrated guide helps clinicians perform better TEE examination and understand structural defects and the relationships between intra-cardiac structures. A DVD demonstrating the latest techniques in TEE is included. Key points Practical guide to transesophageal echocardiography (TEE) of congenital heart disease Covers 3D TEE Highly illustrated with more than 400 images and tables Includes DVD demonstrating latest techniques |
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We offer comfort, reliability and value for money air travel across our network in 50 countries. Our priority is to provide best possible connections to our passengers at suitable timings. Find out …
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Air Rewards, Air Arabia's Loyalty program, is the most generous loyalty program in the region. Based on a simple earn and redeem plan, Air Rewards offers you the maximum value for …
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Enjoy fast track check-ins and boarding, hassle-free immigration processing, convenient porter air travel services and well-equipped lounges to relax in.
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