Based on a literature search, an overview is presented of the pathophysiology of venous and arterial
gas embolism in the experimental and clinical environment, as well as the relevance and aims of diagnostics and treatment of
gas embolism. The review starts with a few historical observations and then addresses venous
air embolism by discussing pulmonary vascular filtration, entrapment, and the clinical occurrence of venous air emboli. The section on arterial
gas embolism deals with the main mechanisms involved, coronary and cerebral
air embolism (CAE), and the effects of bubbles on the blood-brain barrier. The diagnosis of CAE uses various techniques including ultrasound, perioperative monitoring, computed tomography, brain magnetic resonance imaging and other modalities. The section on
therapy starts by addressing the primary treatment goals and the roles of adequate oxygenation and ventilation. Then the rationale for hyperbaric
oxygen as a
therapy for CAE based on its physiological mode of action is discussed, as well as some aspects of
adjuvant drug therapy. A few animal studies are presented, which emphasize the importance of the timing of
therapy, and the outcome of patients with
air embolism (including clinical patients, divers and submariners) is described.