Venous Air Embolism During Lumbar Laminectomy in the Prone Position

Albin, Maurice S.; Ritter, Richard R.; Pruett, Chester E.; Kalff, Karin

doi:10.1213/00000539-199109000-00021

Cited by 102 publications

(48 citation statements)

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“…9 These experimental models suggest that tumors can spread through Batson's plexus. 9 Venous air embolism during spinal surgery 12 and dissemination of infections have also been attributed to the VVS. For example, infections of the urinary tract and after prostatic surgery can spread to the spine causing osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

Metastasis of lung cancer through Batson’s plexus: very rare but possible

Panikkath

Radhi²,

Lim³

et al. 2013

SW Resp Crit Care Chron

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Many malignancies, like prostate, colon, and breast cancer, metastasize throughBatson’s plexus (vertebral venous plexus). Although lung cancer is one of the mostcommon cancers in the United States, its spread through Batson’s plexus is consideredextremely rare. We report a 76-year-old woman with adenocarcinoma of the lung whohad metastasis affecting multiple contiguous vertebral bodies likely due to disseminationthrough Batson’s plexus of veins. This plexus is a component of the cerebrospinalvenous system (CSVS) consisting of the cranial venous system and the vertebralvenous plexus (Batson’s plexus). The CSVS is a valveless network of veins which areimportant in the venous drainage of the brain and spine. However, this venous networkprovides an easy channel for the dissemination of infections and malignant cells.

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Section: Discussionmentioning

confidence: 99%

Metastasis of lung cancer through Batson’s plexus: very rare but possible

Panikkath

Radhi²,

Lim³

et al. 2013

SW Resp Crit Care Chron

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show abstract

“…Similar phenomena leading to fatal outcomes have been reported during lumbar laminectomy in older patients. 7,8 There are two possible sources of nitrogen during laparoscopy: direct entry of room air through a lacerated extraperitoneal vessel and residual air within the endoscopic tubing entering the peritoneum during insufflation and potentially entering the circulation through a bleeding vessel anytime throughout the procedure. The tubing currently in use in our institution for laparoscopy has a volume of 230 mL.…”

Section: Discussionmentioning

confidence: 99%

Gas embolus and cardiac arrest during laparoscopic pyloromyotomy in an infant

Taylor

Hoffman

2010

Can J Anesth/J Can Anesth

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“…6 VAE has also more recently been reported in several other surgical procedures, including lumbar laminectomy and obstetrical procedures; 1 study reported an incidence of 40% during cesarean sections. 7,8 The highest incidence of VAE is found in association with central venous access. VAE can occur during cannulization or later during accessing and use of the catheter.…”

Section: Discussionmentioning

confidence: 99%

Venous Air Embolism During Home Infusion Therapy

2002

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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 ...

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Venous Air Embolism During Lumbar Laminectomy in the Prone Position

Cited by 102 publications

References 0 publications

Metastasis of lung cancer through Batson’s plexus: very rare but possible

Metastasis of lung cancer through Batson’s plexus: very rare but possible

Gas embolus and cardiac arrest during laparoscopic pyloromyotomy in an infant

Venous Air Embolism During Home Infusion Therapy

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