Air embolism secondary to mechanical ventilation is a rare but well-described complication in premature infants. We describe the echocardiographic appearance of venous air embolism manifesting as acute obstruction of the right ventricular outflow tract in such a premature infant, and review the pathophysiology of acute obstruction of the right ventricular outflow tract secondary to the “air lock” phenomenon. Awareness of the pathophysiology and echocardiographic appearance of venous air embolism may aid in prompt recognition and potential therapy for this lethal complication of mechanical ventilation.

We describe a case of paradoxical air embolism during orthotopic liver transplantation, early diagnosis, using intra-operative transoesophageal echocardiography after a circulatory failure, allowed early management by hyperbaric oxygen therapy.

A patient undergoing emergency laparotomy for an acute abdomen developed fatal air embolism as a result of surgical manipulation of a cavitating metastatic lesion of the liver. The diagnosis was made at postmortem examination. This cause of air embolism has apparently not been reported before. The causes and management of air embolism are briefly reviewed. It is concluded that in exceptional circumstances when intubated patients are sent to a recovery area, the continuation of CO2 monitoring into the post-operative period should be considered.