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논문분류	춘계학술대회 초록집
제목	A Case of Venous air Embolism after Contrast Enhanced Computed Tomography in a Patient Undergoing Hemodialysis
저자	Min A Yang, Mun Chul Kim, Jae Woo Park, Hyun Ju Yoon, Cheon Beom Lee,Jeong Gwan Kim, In O Sun, Kwang Yeong Lee
출판정보	2013; 2013(1):
키워드	혈액투석, 공기 색전증/Hemodialysis, Air embolism
초록	Introduction: Venous air embolism (VAE) was reported up to 23% of patients after contrast-enhanced computed tomography (CT) examination, and the majority of emboli are small and not associated with symptoms. We report a successfully treated patient undergoing hemodialysis with large air embolism after contrast-enhanced CT following supportive care including cardiopulmonary resuscitation. Case: A 43-year-old woman with end-stage renal disease undergoing hemodialysis was admitted to treat herpes zoster. For evaluation of cardiomegaly on chest radiography, we performed echocardiography, which showed portal hypertension with left ventricular D-shape. Therefore, she underwent a chest contrast-enhanced CT. Following CT examination, the patient complained dyspnea and her blood pressure dropped to 60/40 mmHg. Initially, we considered her having anaphylactic shock, thus, treated with supportive care. However, the vital sign of the patient was getting worse, and then cardiac arrest was happened. After 3 minutes cardiopulmonary resuscitation, her cardiac rhythm and blood pressure returned to normal. On review of the chest CT, air was seen in left brachiocephalic vein and anterior aspect of superior vena cava without pulmonary thromboembolism. Following diagnosis as VAE, the patient was placed left lateral decubitus position with mechanical ventilator care. After such supportive care for 5 days, repeated CT scan of the thorax revealed no air in the brachiocephalic vein and superior vena cava. And then the patient was discharged without dyspnea. Conclusion: It seems that supportive care including ventilator care and left lateral decubitus position was effective in patient with end stage renal disease undergoing hemodialysis, in case of large venous air embolism requiring resuscitation.
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