Two cases of fatal iatrogenic air embolism confirmed by autopsies

作者全名："Wu, Tong; Wang, Qi; Zhao, Minzhu; Zhu, Ying; Zhang, Li; Li, Yongguo; Li, Jianbo"

作者地址："[Wu, Tong; Wang, Qi; Zhao, Minzhu; Zhu, Ying; Zhang, Li; Li, Yongguo; Li, Jianbo] Chongqing Med Univ, Fac Basic Med Sci, Dept Forens Med, Chongqing 400016, Peoples R China"

通信作者："Li, JB (corresponding author), Chongqing Med Univ, Fac Basic Med Sci, Dept Forens Med, Chongqing 400016, Peoples R China."

来源：JOURNAL OF FORENSIC AND LEGAL MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000703560400001

JCR分区：Q2

影响因子：1.5

年份：2021

卷号：82

期号：　

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结束页：　

文献类型：Article

关键词：Forensic pathology; Air embolism; Hydrogen peroxide; Ureteroscopy; Autopsy

摘要："The occurrence of air embolism is highly related to medical operations, and air embolism can cause sudden death. Such situations require attention in forensic work. This article reports two cases of iatrogenic air embolism confirmed by autopsy. In case 1, air embolism occurred after hydrogen peroxide was used to irrigate and disinfect a wound on the patient's left forearm. Approximately 90 ml of 3% hydrogen peroxide solution was used in case 1, and this volume can produce approximately 890 ml of oxygen by complete decomposition, which is far more than the average lethal air embolism volume. Attention should be given to the risk of air embolism when using hydrogen peroxide for irrigation and disinfection. In case 2, air embolism occurred during left ureteroscopy and stent placement. Due to inappropriate processing, the normal saline pump infused air into the patient at a high pressure of 120 mmHg. Based on our autopsy findings, we discuss the pathways of arterial air embolism and cerebral air embolism. In addition to the air entrainment volume and accumulation rate, the location of air accumulation also significantly impacts the risk of air embolism. After an arterial air embolus develops into a coronary and/or cerebral air embolus, the lethal air volume drops to only a few milliliters."

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