Frequency – Central Line Related Air Emboli

1. How many central lines are inserted per year?

In US an estimated 6 million lines inserted per year and increasing.

5 million per year in US (NEJM 2003)

More than 5million per year in US. Approximately 8% of hospitalised patients.

As many as 5million CVCs per yr in US. 15% experience complications.

48% of ICU patients. 15million CVC days per year in US.

Estimated 200,000 CVCs per year in NHS (BMJ 2013)

2. What proportion of the central lines are complicated by air emboli?

0.2 to 1% of CVCs

0.2 to 1% of CVCs

Incidence may be as high as 0.8% (AAGBI)

1 in 47 to 1 in 3000 cases

1 in 772 

1 in 800

0.1 to 2% of CVC insertions

0.13 to 0.5% of insertions

0.13% of interventional radiology CVC manipulations

15 of 11,583 radiographically inserted central lines

(Gas embolism complicates 2.65 per 100,000 hospitalizations)

3. What proportion of the air emboli result in death?

Mortality rate 23 to 50%

Mortality rate 23%

Review of 24 cases – 50% died, of remainder 42% had permanent neurological injury

Review of 26 cases – 23% died

4 out of 10 cases resulted in death

Mortality rate up to 30%