Air Embolism: Hemodynamics and Therapy

Venous Air Embolism in Head and Neck Surgery

“…21 As the volume injected becomes greater, the Doppler signal becomes louder and more prolonged. In comparison, the typical mill wheel sound heard by auscultation will not be evident until 15 to 30 ml is injected. 21 The Doppler method is effective because the air-blood interface is an excellent reflector of the 2.5 MHz ultrasonic signal it produces.• The Doppler monitor is positioned where the high-pitched swishing of intracardiac air is loudest.• This will normally be just to the right or left of the sternum above the xiphoid.…”

Body Position Does Not Affect the Hemodynamic Response to Venous Air Embolism in Dogs

“…Although the pathophysiology of VAE has been well documented (9,12,14,17,(20)(21)(22)(23), there has been little investigation into the hemodynamic benefits of body positioning for the treatment of VAE. This is important, because the efficacy of this therapy has been questioned (12,17).…”

“…In other words, if there were differences in the survival rates between different body positions, one would also expect differences in the hemodynamic responses. We therefore chose an air dose which was not associated with as high a mortality as previously evaluated (14,22). Since the average lethal dose of air in dogs has been found to be between 3.0 and 7.5 mL/kg (21,22,(24)(25)(26), we selected a dose of 2.5 mL/ kg.…”

Review article : Gaseous microemboli: a review

“…A number of reports have reviewed the physiological and pathological consequences of arterial air embolism. 92,93,104,105,[226][227][228] Although the pathologies of gross air embolism include many complications previously described for GME, the bubbles are usually of a greater diameter, producing symptoms that are likely to be more pronounced since a greater percentage of blood flow is obstructed. In the brain, EEG changes may occur seconds after an embolism and persist for hours after recovery.…”