Transesophageal Echocardiography and Transcutaneous O2 and CO2 Monitoring for Detection of Venous Air Embolism

Glenski, James A.; Cucchiara, Roy F.; Michenfelder, John D.

doi:10.1097/00000542-198605000-00001

Cited by 102 publications

(47 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Тяжесть легочного повреждения варьирует от бессимптом-ного до ОРДС [1,2]. При наличии открытого оваль-ного окна или внутрилегочного шунта создаются предпосылки для попадания воздуха в большой круг кровообращения [1,2,6,14]. При этом могут воз-никать ишемические повреждения любых органов, однако наиболее часто поражаются головной мозг, кожные покровы, миокард [1,2,5].…”

Section: Discussionunclassified

“…В нейрохирургической практике ПВЭ наиболее часто встречается при операциях в поло-жении сидя либо в положении с возвышенным го-ловным концом -как вторичное осложнение ве-нозной воздушной эмболии [1][2][3][4]. Внутрисердеч-ное шунтирование через не полностью заращенное овальное окно -наиболее частая причина ПВЭ, но к парадоксальной эмболии во время анестезии мо-жет привести и функционирование внутрилегочных артериовенозных шунтов [5,6]. Потенциально эти воздушные эмболы могут попасть в любые артери-альные сосуды, однако чаще всего отмечается их по-падание в сосуды головного мозга (ветви средней мозговой артерии) [1,2].…”

Section: список сокращенийunclassified

See 1 more Smart Citation

Paradoxical air embolism resulted in acute myocardial infarction and massive ischemic brain injury in a patient operated on in a sitting position

et al. 2016

Vopr. neirokhir.

View full text Add to dashboard Cite

Section: Discussionunclassified

Section: список сокращенийunclassified

Paradoxical air embolism resulted in acute myocardial infarction and massive ischemic brain injury in a patient operated on in a sitting position

et al. 2016

Vopr. neirokhir.

View full text Add to dashboard Cite

“…In order of sensitivity, the options to detect air within the vasculature and document VAE include echocardiography (transthoracic or transesophageal), precordial Doppler, end-tidal nitrogen monitoring, and auscultation of the previously mentioned mill-wheel murmur. 11 Large volumes of air can be documented by chest radiograph if the volume is large enough and still present in the heart. If the patient already has a central line in place, then it is rarely possible to aspirate air from the catheter.…”

Section: Discussionmentioning

confidence: 99%

Venous Air Embolism During Home Infusion Therapy

2002

View full text Add to dashboard Cite

ABSTRACT. Venous air embolism (VAE) is a potential complication of surgical procedures as well as central venous access. There are several reports in the literature of VAE during the in-hospital use and placement of central venous access. However, we are unaware of previous cases of VAE in children who received home infusion therapy via central venous access.We report the occurrence of a VAE in a 2-year-old with a Broviac catheter for home intravenous antibiotic therapy. VAE occurred when a bolus of air was unintentionally administered as the mother removed the cassette from the pump when it was alarming air in line. The cassette and tubing had been placed into the pump without a fluid flush. After the tubing and cassette were removed from the pump, the air in the line was allowed to flow by gravity into the patient, resulting in the immediate onset of respiratory and neurologic symptoms. The mother administered 2 rescue breaths, and the child's color and breathing returned to normal over the next 2 minutes. After the child arrived in the emergency department, the child's mental status returned to normal and the remainder of her physical examination was unremarkable. She had an uneventful recovery and was discharged from the hospital the following day. Additional antibiotic administration was accomplished in the emergency department of a local hospital.VAE can occur spontaneously when there is an open venous structure 5 cm or more above the heart or if air is delivered under pressure into the venous system, such as during a laparoscopy or mishaps with infusion bags. The morbidity and mortality of VAE are related to the volume of air, rate of entrainment, the patient's underlying cardiorespiratory status, and the patient's position. Morbidity and mortality occur as a consequence of right ventricular outflow obstruction or end-organ dysfunction from left-sided obstruction of coronary or cerebral vasculature as air passes across a patent foramen ovale or through the pulmonary circulation.Of all the literature pertaining to VAE with central lines, there are no previous reports of VAE occurring during home infusion therapy in children. With managed care requiring shorter hospitalizations and more children being discharged from the hospital on home infusion therapy, parents and lay caregivers are being asked to administer medications and perform routine maintenance on central venous devices. In our case, despite the fact that the mother had been educated regarding the appropriate technique for medication administration, she forgot to purge the air from the line before connecting the tubing and administering the antibiotic. Although the infusion pump will alarm when there is air in the line, it detects air only in a small part of the line and this safety feature is not in play if the device is removed from the infusion pump and administered via gravity. If such safety precautions are not adhered to, then the volume of air that fills the intravenous tubing from the drip chamber to the patient (25-30 mL in the pediatric ...

show abstract

“…5 Continuous echocardiography can detect intravascular air by identifying bubbles in the cardiac cavities. 6 From a pathophysiological view, air enters the pulmonary venous system when the intravascular pressure is lower than the bronchial/alveolar air pressure and is the basis for avoiding high pressure ventilation settings in these patients. 4,7,8 Systemic air embolism triggers neurological dysfunction.…”

Section: Introductionmentioning

confidence: 99%

Massive cerebral air embolism after blunt chest trauma with full neurological recovery

Reith

Bouillon

Sakka

et al. 2015

CJEM

View full text Add to dashboard Cite

Cerebral air embolism (CAE) is a common, often lethal, complication in blunt and penetrating chest trauma. The factors affecting the outcome of CAE patients are poorly understood, and there is no generally accepted treatment algorithm. In this report, we present the case of a 28-year-old male motorcyclist with a massive CAE, including bilateral internal carotid artery air on computed tomographic examination following blunt chest trauma. With prehospital intubation, oxygen, transfusion, and open laparotomy but without any specific treatment regarding the CAE, a follow-up computed tomography (CT) scan approximately 6 hours later showed resolution of the cerebrovascular air. Recovery was unremarkable, and the patient was discharged neurologically intact after 22 days.

show abstract

Transesophageal Echocardiography and Transcutaneous O2 and CO2 Monitoring for Detection of Venous Air Embolism

Cited by 102 publications

References 0 publications

Paradoxical air embolism resulted in acute myocardial infarction and massive ischemic brain injury in a patient operated on in a sitting position

Paradoxical air embolism resulted in acute myocardial infarction and massive ischemic brain injury in a patient operated on in a sitting position

Venous Air Embolism During Home Infusion Therapy

Massive cerebral air embolism after blunt chest trauma with full neurological recovery

Contact Info

Product

Resources

About