Correspondence

doi:10.1046/j.1460-9592.1997.d01-464.x

Cited by 3 publications

(1 citation statement)

References 2 publications

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“… 11 18 19 Other studies have proposed the use of a transiently inflated tourniquet around the neck. 20 21 In recent work by Frydrychowski and co-workers, jugular vein compression was achieved using a sphygmomanometer. 22 The cuff was inflated to 40 mm Hg for 3 min in healthy volunteers while monitoring cerebral blood flow velocity and pial artery pulsation.…”

Section: Discussionmentioning

confidence: 99%

Intrajugular balloon catheter reduces air embolism in vitro and in vivo

Eckle¹,

Neumann²,

Greiner³

et al. 2015

British Journal of Anaesthesia

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BackgroundNeurosurgical procedures requiring a sitting position may put the patient at risk of a potentially life-threatening air embolism. Transient manual jugular venous compression limits further air entry in this situation. This study presents an alternative technique aimed at reducing the risk of air embolism.MethodsIn an in vitro model, an intrajugular balloon catheter was inserted to demonstrate that this device prevents air embolism. In an in vivo study, this device was bilaterally placed into jugular vessels in pigs. Using an ultrasound technique, blood flow was monitored and jugular venous pressure was recorded before and during cuff inflation. Air was applied proximally to the inflated cuffs to test the hypothesis that this novel device blocks air passage.ResultsIn vitro, the intrajugular balloon catheter reliably prevented further air entry (n=10). Additionally, accumulated air could be aspirated from an orifice of the catheter (n=10). In vivo, inflation of the catheter balloon completely obstructed venous blood flow (n=8). Bilateral inflation of the cuff significantly increased the proximal jugular venous pressure from 9.8 (2.4) mm Hg to 14.5 (2.5) mm Hg (n=8, P<0.05). Under conditions mimicking an air embolism, air passage across the inflated cuffs was prevented and 78 (20%) (n=6) of the air dose could be aspirated by the proximal orifice of the catheter.ConclusionsThese findings may serve as a starting point for the development of intrajugular balloon catheters designed to reduce the risk of air embolism in patients undergoing neurosurgery in a sitting position.

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