Coronary Artery Air Embolism in the Non–operating room Anesthesia Setting: Comment

Abstract

W e would like to thank Hess and Long 1 for their comments on our article, 2 who emphasized the role of acidemia-associated coagulopathy in terms of decreasing fibrinogen concentration, reducing coagulation factors and promoting a state of hypocoagulability. Furthermore, the correction of the state of acidemia with bicarbonate infusion does not correct or alleviate coagulopathy, suggesting that, in the presence of hemorrhagic shock, it is mandatory to avoid or decrease the severity of acidemia and hypothermia to improve outcome. [3][4][5]

Coronary Artery Air Embolism in the Non–operating room Anesthesia Setting: Reply

“…Moon and Camporesi in the field of undersea and hyperbaric medicine and thank them for their input on this topic. 1,2 We readily acknowledge that the Trendelenburg position is detrimental to patients with intracranial hypertension and known cerebral air embolism. Our recommendation focused on the use of the Trendelenburg position for the prevention of cerebral air embolism in the setting of aortic air embolism, acknowledging that the data on this topic are sparse.…”