Body Position Does Not Affect the Hemodynamic Response to Venous Air Embolism in Dogs

Mehlhorn, Uwe; Burke, E.A.; Butler, Bruce D; Davis, Karen L.; Katz, Jeffrey A.; Melamed, Evan; Morris, William P.; Allen, Steven J.

doi:10.1213/00000539-199410000-00020

Cited by 55 publications

(30 citation statements)

References 26 publications

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“…The consequences of air embolism can be minimized by placing the patient in a 15 degree Trendelenburg position [72–74]. However, recent literature has questioned the efficacy of Trendelenburg position on improving hemodynamics [75].…”

Section: Resultsmentioning

confidence: 99%

Anesthetic Considerations in Hepatectomies under Hepatic Vascular Control

et al. 2012

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Background. Hazards of liver surgery have been attenuated by the evolution in methods of hepatic vascular control and the anesthetic management. In this paper, the anesthetic considerations during hepatic vascular occlusion techniques were reviewed. Methods. A Medline literature search using the terms “anesthetic,” “anesthesia,” “liver,” “hepatectomy,” “inflow,” “outflow occlusion,” “Pringle,” “hemodynamic,” “air embolism,” “blood loss,” “transfusion,” “ischemia-reperfusion,” “preconditioning,” was performed. Results. Task-orientated anesthetic management, according to the performed method of hepatic vascular occlusion, ameliorates the surgical outcome and improves the morbidity and mortality rates, following liver surgery. Conclusions. Hepatic vascular occlusion techniques share common anesthetic considerations in terms of preoperative assessment, monitoring, induction, and maintenance of anesthesia. On the other hand, the hemodynamic management, the prevention of vascular air embolism, blood transfusion, and liver injury are plausible when the anesthetic plan is scheduled according to the method of hepatic vascular occlusion performed.

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Section: Resultsmentioning

confidence: 99%

Anesthetic Considerations in Hepatectomies under Hepatic Vascular Control

et al. 2012

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“…Death can result from large volumes of gas entering the venous system over a short period of time. The average lethal bolus dosage of intravenous air in dogs is between 3.0 and 7.5 ml/kg, 13–16 while slow introduction of air (up to 1400 ml over several hours) is better tolerated 4 . Smaller animals are evidently more susceptible: the LD 50 in rabbits has been reported as 0.55 ml/kg 4 .…”

Section: Discussionmentioning

confidence: 99%

Fatal Venous Air Embolism in a Cat With a Retropharyngeal Diverticulum

Ober

Spotswood

Hancock

2006

Vet Radiology Ultrasound

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A cat with a 1-year history of oropharyngeal foreign bodies was diagnosed with a pharyngeal diverticulum. The cat experienced fatal cardiac arrest during endoscopy, and postmortem radiographs and ultrasound revealed venous air embolism. Venous air embolism is uncommonly reported in veterinary medicine, but is a risk during any procedure that introduces air into a body cavity. Precautions should be taken during these procedures to help minimize the risk of adverse events.

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“…But Smulders, Zheng et al and Mehlhorn et al contend other forces operate than body posture. [28][29][30] Smulders deliberated on the issue of pulmonary vasoconstriction and bronchospasm, "Furthermore, bringing about a strictly mechanical obstruction by cross clamping the left or right pulmonary artery during a surgical procedure, or by unilateral balloon occlusion, causes only a modest rise in pulmonary artery pressure (PAP), and almost never results in right sided heart failure, whereas PE (pulmonary embolism) with obstruction of only ±25% of the pulmonary vascular tree can cause marked pulmonary hypertension. Also, major PE can be found during autopsy in patients who never had any clinical manifestations of PE."…”

Section: Mechanism Of Gas Lock Versus Embolism and Pulmonary Reactionsmentioning

confidence: 99%

“…31 There is increased vasodilation, capillary permeability with noncardiogenic pulmonary edema, right to left shunting; more dead space, hypoxia, hypercapnia, ventilation perfusion mismatch, wheeze and bronchospasm; accentuating TJ further. 29,30 It can lead to acute respiratory distress syndrome, systemic inflammatory response syndrome aggravated by infection leading to multiple organ dysfunction syndrome and disseminated intravascular coagulation with diffuse fatal bleeding.…”

Section: Kumar S Et Al Int Surg J 2018 Apr;5(4):1164-1170mentioning

confidence: 99%

Threshing grain of mechanism from chaffy myth of air embolism in laparoscopy - lux et veritas

Kumar

Sudrania

2018

Int Surg J

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Biomechanical processes involving exact mechanism of air embolism (AE) or gas embolism (GE) in pneumoperitoneum (PP) in operative laparoscopy (OL) causing morbidity and mortality lie in air lock (AL) or gas lock (GL) in right side of heart resulting in traffic jam (TJ) for blood flow in pulmonary tree (PT). This also leads to poorly understood cascade of immunopathological pulmonary reactions. These issues are critically reviewed and discussed to thresh the grain of mechanism from husk of myth of ghost of AE or GE in OL for its dreaded moribund complications. Physics of gas is defined with analysis that venous GE is not exclusive to ambient air (AA) in OL but occurs with CO2, N2O, O2 and other gases also. It is important since use of AA in OL is useful or ostensibly better than CO2 in situations like pregnancy, camps, cardiopulmonary cripples, cirrhotics, war fields, etc and economic needing no cylinders as AA is ubiquitous. Even when gas used was or is CO2 or O2 but blemish is labelled on air for embolism imprudently needing scientific scrutiny.

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Body Position Does Not Affect the Hemodynamic Response to Venous Air Embolism in Dogs

Cited by 55 publications

References 26 publications

Anesthetic Considerations in Hepatectomies under Hepatic Vascular Control

Anesthetic Considerations in Hepatectomies under Hepatic Vascular Control

Fatal Venous Air Embolism in a Cat With a Retropharyngeal Diverticulum

Threshing grain of mechanism from chaffy myth of air embolism in laparoscopy - lux et veritas

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