Article

Massive Transient Pulmonary Air Embolism During Pacemaker Implantation Under Mild Sedation:

Department of Cardiology, Ha'Emek Medical Center, Afula, Israel.
Pacing and Clinical Electrophysiology (Impact Factor: 1.25). 06/2004; 27(5):684-5. DOI: 10.1111/j.1540-8159.2004.00510.x
Source: PubMed

ABSTRACT We present a case of a massive pulmonary air embolism during permanent pacemaker lead implantation under mild sedation in a 73-year-old woman. We used a peel-away sheath that is devoid of a hemostatic valve. The air embolism occurred after deep inspiration associated with loud snoring sounds and resolved after short chest massage and administration of adrenaline. Temporary closure of the intravenous entrance route of the peel-away sheath before inserting the lead may prevent this potentially lethal complication.

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    • "Three main issues are important in diagnosis and management of this problem: (1) deep inspiration should be avoided in the presence of an open intravenous route; (2) when using a peal-away sheath, temporarily close the intravenous entrance route before inserting the lead; and (3) snoring may be an alarm sound! (Turgeman et al., 2004). "
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