Bunegin-Albin Catheter Improves Air Retrieval and Resuscitation from Lethal Venous Air Embolism in Upright Dogs

Cardiac air transit following venous air embolism and right ventricular air aspiration*

“…Air recovery is reported to range from 24.2% to 80% in animal studies [15,21,27,28] and depends on air entrainment over time, the detection technique, and the type of catheter used for aspiration [15,27,28]. Aspirating embolised air via a multi-orifice central venous catheter placed within the right atrium is considered to be the gold standard [14].…”

“…Right atrial aspiration will not recover any air that does this. Although the upper right atrium has been suggested as the optimum position for catheter tip placement and aspiration of gas emboli [14,15], right ventricular aspiration might be a more rationale choice.…”

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

“…We therefore chose an air dose which was not associated with as high a mortality as previously evaluated (14,22). Since the average lethal dose of air in dogs has been found to be between 3.0 and 7.5 mL/kg (21,22,(24)(25)(26), we selected a dose of 2.5 mL/ kg. A rapid rate of infusion (5 mL/s) was selected to mimic the clinical situation of massive VAE.…”

Intracardiac Transvenous Echocardiography Is Superior to Both Precordial Doppler and Transesophageal Echocardiography Techniques for Detecting Venous Air Embolism and Catheter-Guided Air Aspiration

“…22 Afterwards, the upper right atrium was visualized by ICE and the CVC was positioned with its tip within the upper 20 mm of the right atrium, as this position is reported being optimal for aspiration of venous gas emboli. 13,23 Measurements A commercially available ultrasound machine (Sequoia C256, Siemens, Erlangen, Germany) was used for all echocardiographic studies.…”

“…Air recovery varies widely from 24.2% to 80%, depending on injected air volume and injection site. [12][13][14][15] Intracardiac echocardiography (ICE) provides a unique high-quality image of the right heart cavities and is routinely used in cardiology for guidance of ablation catheters or patent foramen ovale closure procedures. 16 -19 Thus, we tested the hypotheses that ICE improves 1) detection of small air emboli, and 2) recovery of intracardiac air after larger volume VAE.…”