Methods:
The patient was suspected to have pulmonary air embolism due to the
sudden deterioration from a stable clinical condition following the
removal of his right jugular venous catheter. A CXR was ordered bedside
and showed congested lungs (Figue-02) and bed side echocardiography
showed air bubbles in the left side of the heart and the diagnosis of
air pulmonary embolism was confirmed (Figure-1). He was fully conscious
throughout the event. He was put in the left lateral decubitus position
with head down and was shifted to the intensive care unit. In the ICU,
he was kept on high flow nasal canula and hyperbaric oxygen therapy was
arranged for him after 4 hours. After receiving hyperbaric oxygen, he
showed dramatic improvement and stayed for observation in the ICU for a
few days then shifted back to the medical floor and was discharged
safely home.
Figure-01 (Echocardiography with Apical four chamber view of the heart
showing multiple air bubbles in the left ventricle and left atrium (
yellow arrows))