Venous air embolism: ultrasonographic diagnosis and treatment with hyperbaric oxygen therapy

A man with neuromuscular respiratory failure requiring intubation and ventilation suffered a venous air embolism during inadvertent administration of 5 ml of air. Ultrasound (US) imaging confirmed an air embolus in the left subclavian vein, which was only partially treated by US-guided aspiration. The embolus completely resolved on US imaging during hyperbaric oxygen therapy, and the patient recovered with no complications secondary to the embolism. Venous air embolism is under-recognised, and can cause siginificant neurological morbidity and death if untreated. When available, urgent hyperbaric oxygen therapy appears to be an effective approach.