Gas embolism in anaesthesia

Venous, arterial and paradoxical air emboli are potential complications in many of the clinical scenarios encountered anaesthetists. Capnography is easy to use, routinely available and should detect most clinically significant emboli. In high risk situations, prevention is better than cure and it is essential that the appropriate preventative measures, monitoring tools and treatment modalities are in place. Vigilance and good communication between all clinicians involved is essential. the event of a large embolism, cardiopulmonary resuscitation may be required. Additional treatment is aimed at preventing further air entry, overcoming the air lock and reducing the size of the embolism. Paradoxical air embolism may occur in absence of a PFO. The treatment of choice for significant arterial air emboli is hyperbaric oxygen therapy.