Venous air embolism occurring after removal of a central venous catheter.

A 77-yr-old woman was admitted to St. Luke's Hospital for repair of an abdominal aortic aneurysm. A balloon-tipped, flow-directed pulmonary artery catheter was inserted using a Cordis sheath in the right internal jugular vein after the induction of general anesthesia. She then underwent uneventful repair of the aneurysm and was transferred out of the surgical intensive care unit on the second postoperative day after an uneventful course in the unit. At the time of transfer the pulmonary artery catheter was removed, but the Cordis sheath was left in place. On the fourth postoperative day the Cordis sheath was removed and a dressing of povidone-iodine ointment and 2 x 2 gauze was placed over the wound with a single strip of adhesive tape. Approximately 15 min after the Cordis sheath was removed, she walked to the bathroom, and within moments of standing she complained of feeling dizzy. When she returned from the bathroom the nurse helping her reported that she suddenly collapsed onto the bed and became unresponsive to verbal queries, although she had her eyes open. On telemetry monitoring she was found to