Air embolism during operative hysteroscopy: TEE-guided resuscitation

Sabsovich, Ilya; Abel, Mark F.; Lee, Christen J.; Spinelli, Allison; Abramowicz, A. Elisabeth

doi:10.1016/j.jclinane.2012.01.002

Cited by 18 publications

(13 citation statements)

References 66 publications

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“…Gas embolism seems to occur in most patients, correlates with fluid absorption and occurs more often with bipolar diathermy as compared with monopolar diathermy . Case reports may describe the clinical appearance of gas embolism during TCER very much alike our case B, but the hyperchloremia would not have developed in the absence of fluid absorption.…”

Section: Discussionmentioning

confidence: 64%

See 1 more Smart Citation

Symptomatic absorption of isotonic saline during transcervical endometrial resection

Johansson

Lindahl

Gyllencreutz

et al. 2016

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 64%

“…This could have happened when end‐tidal CO 2 suddenly dropped. Gas embolism is a feared complication and its severity varies from no symptoms to death . Gas embolism seems to occur in most patients, correlates with fluid absorption and occurs more often with bipolar diathermy as compared with monopolar diathermy .…”

Section: Discussionmentioning

confidence: 99%

Symptomatic absorption of isotonic saline during transcervical endometrial resection

Johansson

Lindahl

Gyllencreutz

et al. 2016

Acta Anaesthesiol Scand

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“…Paradoxical emboli may cause myocardial ischemia and ECG changes such as right bundle branch block [10]. ST-segment changes usually occur in the inferior leads, as the right coronary artery is more likely to trap paradoxical emboli.…”

Section: Discussionmentioning

confidence: 99%

Venous Air Embolism during Hysteroscopic Myomectomy: An Analysis of 7 Cases

Dijck

Rex²,

Verguts³

et al. 2017

Gynecol Obstet Invest

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Venous air embolism (VAE) is a rare but potentially fatal complication of hysteroscopic myomectomy. The symptoms of VAE range from mild and clinically insignificant to complete cardiovascular collapse during surgery. Anesthesiologists and surgeons should be aware of the clinical characteristics and predisposing factors of this possible adverse event. This report analyzes 7 cases of VAE, which occurred at the University Hospitals Leuven, in patients undergoing hysteroscopic myomectomy from April 2009 to April 2011. Patient and myoma characteristics were compared to a control group of 27 patients who underwent uneventful hysteroscopic myomectomy during the same period of time. Analysis of baseline data including myoma size failed to identify predisposing factors. Clinical events in this series were classified according to their severity as minor (causing respiratory symptoms in 2 cases), moderate (accompanied by hemodynamic instability in 5 cases), or severe (requiring resuscitation in no cases). Case characteristics and therapeutic strategies in all cases were compared to reports from recent literature.

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“…Air entrainment usually presents as a rapid onset of haemodynamic compromise with fall in pO 2 and rise in pCO 2 . Clinical diagnosis of VAE may be very difficult as it can mimic other, more common conditions like severe hypovolaemia, myocardial ischaemia or inferior vena cava compression related to torsion of the liver ( 1 ) . The techniques available for detection of VAE include TOE, transthoracic echocardiography (TTE), pulmonary artery catheterization, and monitoring of endexpiratory carbon dioxide tension or central venous pressure.…”

Section: Discussionmentioning

confidence: 99%

Will transoesophageal echocardiography become a standard tool for anesthetists to assess haemodynamic status during non-cardiac surgeries? Case report and literature review

2014

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A 53-year-old male, with no history of cardiovascular diseases, underwent elective extended right hemihepatectomy for large metastatic tumor. Approximately 2 hours after the start of procedure sudden onset of severe hypotension associated with profound desaturation and significant fall in end-tidal carbon dioxide pressure was noted. Transoesophageal echocardiography was performed and massive air embolism was confirmed. Patient was turned into Trendelenburg position, inspired oxygen was increased to 100% and positive end-expiratiory pressure turned up to 10 cm H20. Patient was further resuscitated with iv fluids, blood products and vasopressors under surveillance of transoesophageal echocardiography. In this report we present a case in which intraoperative use of transoesophageal echocardiography by trained anaesthetist helped to immediately identify the cause of sudden hypotension and hypoxaemia. Transoesophageal echocardiographywas also a valuable tool for direct monitoring of efficacy of instituted treatment.

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Air embolism during operative hysteroscopy: TEE-guided resuscitation

Cited by 18 publications

References 66 publications

Symptomatic absorption of isotonic saline during transcervical endometrial resection

Symptomatic absorption of isotonic saline during transcervical endometrial resection

Venous Air Embolism during Hysteroscopic Myomectomy: An Analysis of 7 Cases

Will transoesophageal echocardiography become a standard tool for anesthetists to assess haemodynamic status during non-cardiac surgeries? Case report and literature review

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