Suspected fatal venous air embolism during anaesthesia in a Pomeranian dog with pulmonary calcification

Walsh, V P; Machon, R.G.; Munday, JS; Broome, C J

doi:10.1080/00480169.2005.36576

Cited by 18 publications

(18 citation statements)

References 14 publications

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“…Im akuten Zustand ist dies aufgrund der Unkoordiniertheit der Tiere und der bestehenden Ataxie als zu gefährlich einzustufen. Eine computertomographische Untersuchung des Gehirns war aufgrund der notwendigen Sedation und Narkose in den vorliegenden Fällen ebenso als zu komplikationsreich anzusehen (Walsh et al 2005, Gunew et al 2008, Pellegrini-Masini et al 2009, Heng et al 2014, Suri et al 2014, Reith et al 2015. Zusammenhang mit der vorangegangen Thorakoskopie nicht auszuschließen, allerdings wurden in der Literatur bei ähn-lichen Eingriffen solche Komplikationen nicht beobachtet (Scharner 2012).…”

Section: Patientunclassified

“…Aufgrund der Ähnlichkeit der Symptome mit den Beschreibungen in der Literatur in unmittelbarem zeitlichen Zusammenhang mit dem Auffinden einer nicht verschlossenen Katheterverbindung, kann eine Luftembolie als Ursache jedoch vermutet werden (Bradbury et al 2005, Holbrook et al 2007, Caporelli et al 2009, Pellegrini-Masini et al 2009 (Walsh et al 2005, Gunew et al 2008, Pellegrini-Masini et al 2009). …”

Section: Patientunclassified

“…Eine Möglichkeit ist eine hyperbare Sauerstofftherapie zur Sicherstellung der ausreichenden Oxygenierung des Körpers (Pellegrini-Masini et al 2009, Tekle et al 2013 (Bradbury et al 2005, Holbrook et al 2007, Sams und Hofmeister 2008, Caporelli et al 2009, Pellegrini-Masini et al 2009). In der Kleintiermedizin und Humanmedizin hingegen wird häufiger ein fataler Ausgang berichtet (Walsh et al 2005, Gunew et al 2008, Reith et al 2015. …”

Section: Patientunclassified

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Clinical presentation and short-term outcome in two horses with suspected air embolism

Gittel¹,

Delling²,

Brehm³

et al. 2016

PHK

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Complications associated with intravenous catheters have been reported frequently and are not only limited to thrombophlebitis of the respective vessel. There are some reports of air embolism in small and large animals described in the literature. The source of air aspiration can be traumatic, iatrogenic during surgeries and also related to venous catheters. Not only the reason for air aspiration, but also the consequences differ between human, small animals and horses. This present article describes the clinical signs, treatment and short-term outcome of two horses with suspected venous air embolism but with different underlying diseases. Both horses exhibited a sudden onset of cardiovascular shock and periods of neurological disorder during their hospitalization. One horse also showed colic symptoms. In both horses an inadvertently opened venous catheter was found at the onset of unexpected symptoms. Therefore, air embolism due to air aspiration by the open venous access might be possible. In air embolism, a decreased perfusion and reduced oxygen delivery are potential sequelae. An impairment of the cardiovascular system with subsequent cerebellar hypoperfusion and embolism might be an explanation for the observed clinical signs. These were tachycardia, delayed capillary refill time and excitement. Furthermore, ataxia, seizures and blindness was observed. Intensity and duration of clinical signs differed between both horses. Following supportive treatment, both horses were discharged from hospital in a good condition. The exact amount of air leading to clinical signs is not exactly known despite different studies aiming at finding a lethal dose. However, rate and amount of air aspiration, as well as body weight and health status of the patient may also have an effect on occurrence of overt clinical signs of venous air embolism. Due to the lack of specific treatment options, symptomatic therapy has been performed. This includes intravenous fluid administration for cardiovascular stabilization and anti-inflammatory treatment. Additionally, nasal oxygen insufflations may increase tissue oxygenation. Furthermore, neuroprotectiv treatment, like dexamethason, might also be advantageous regarding the pathophysiology of venous and cerebellar air embolism. Antithrombotic treatment can be initiated in order to avoid formation of thrombus following capillary perfusion disturbances in the circulation. Diagnostic proof is lacking in both cases, however, presence of an open venous catheter and the observed clinical signs lead to the suspected diagnosis of venous air embolism. Venous air embolism seems to have a low incidence in equine medicine, and the exact dimension of clinical signs may not always be obvious. Close attention should be paid at infusion lines, air within syringes, disconnection of catheters and their extensions and catheter caps. Problems may occur due to manipulations by the horse itself or due to improper handling by the attending veterinarian. Several medical devices aim at reducing the risk of air aspi...

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Section: Patientunclassified

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Clinical presentation and short-term outcome in two horses with suspected air embolism

Gittel¹,

Delling²,

Brehm³

et al. 2016

PHK

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“…1,2 The lesson of this case underscores the importance of having only one person responsible for setting up and instituting fluid therapy in the patient.…”

Section: Drug Delivery: Venous Accessmentioning

confidence: 99%

Drug Administration

Quandt¹,

Olmstead²

2012

Advanced Monitoring and Procedures for Small Animal Emergency and Critical Care

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“…ΚΑΤΣΙΜΠΟΥΛΑΣ, Ι. ΚΑΚΙΣΗΣ, Μ. ΠΕΡΟΥΛΗΣ, Κ. ΔΗΜΗΤΡΙΟΥ, Ε. ΜΠΑΛΑΦΑΣ, Ν. ΚΩΣΤΟΜΗΤΣΟΠΟΥΛΟΣ Η εμβολή από αέρα της φλεβικής κυκλοφορίας, τόσο στον άνθρωπο όσο και στα ζώα, είναι μία σχετικά σπάνια επιπλοκή ιατρογενοΰς κυρίως αιτιο λογίας, που μπορεί να οδηγήσει ακόμα και στο θάνα το του οργανισμού (Muth and Shank 2000). Όπως α ναφέρεται από τους Gorman και Mitchell, η πρώτη περιγραφή περιστατικού φλεβικής εμβολής σε άν θρωπο έγινε από τον Magendie το 1821.Οι βιβλιο γραφικές αναφορές σε ανάλογα περιστατικά σε ζώα είναι πολΰ περιορισμένες (Thayer GW et al 1980, Walsh VP et al 2005, Bradbury LA et al 2005, Ober CP et al 2006) σε αντίθεση με την αντίστοιχη ιατρική βιβλιογραφία, όπου τα περιστατικά είναι πολυάριθ μα. Αυτό μπορεί να εξηγηθεί από την αδυναμία διά γνωσης της επιπλοκής αυτής στα ζώα.…”

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Fatal venous air embolism in swine during surgical procedure

Katsimpoulas

Kakisis

Peroulis

et al. 2018

J Hellenic Vet Med Soc

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Air embolism can occur after minor invasive procedures, as well as during major surgical operations. Reports of air embolism cases in veterinary literature are not very often, although it is considered that it happens more often than it is recognized. During a surgical procedure in swine, for the creation of a fistula of PTFE graft between the right common carotid artery and the right jugular vein under general anaesthesia, the animal died due to massive venous air embolism. Although it is supposed that the air was possibly inserted through the anaesthetic machine or through the anastomosis, the exact mechanism of the air insertion remains unknown.

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Suspected fatal venous air embolism during anaesthesia in a Pomeranian dog with pulmonary calcification

Abstract: In this case of VAE-associated anaesthetic death, it is further speculated that underlying pulmonary disease, in the form of pulmonary calcification, may have contributed to an increased sensitivity to the adverse effects of VAE.

Cited by 18 publications

References 14 publications

Clinical presentation and short-term outcome in two horses with suspected air embolism

Clinical presentation and short-term outcome in two horses with suspected air embolism

Drug Administration

Fatal venous air embolism in swine during surgical procedure

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