Closed-Chest Cardiac Massage in the Treatment of Venous Air Embolism

Ericsson, Judith A.; Gottlieb, Joel D.; Sweet, Robert B.; Hamilton, William K.

doi:10.1097/00132586-196504000-00035

Cited by 3 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The distribution of intravascular gas in this case included both venous and arterial systems, right and left ventricles, and the splenoportal venous system. Venous air embolism in infants may occur in neurosurgical operations, cardiac surgery, epidural procedures, and umbilical vein catheterization (1–4). Documentation of air in the venous system following known or experimental introduction of air into arteries has implicated the cerebral circulation as a conduit for intravascular gas (5).…”

Section: Discussionmentioning

confidence: 99%

Infant Death Due to Air Embolism from Peripheral Venous Infusion

Sowell

Lovelady

Brogdon

et al. 2006

Journal of Forensic Sciences

View full text Add to dashboard Cite

An otherwise healthy male infant was brought to the hospital because the mother suspected superficial infection at the operative site 5 days after an inguinal hernia repair. He was admitted to the pediatric unit overnight to be evaluated by his surgeon the next morning. When a venous infusion of maintenance fluids was started, the patient immediately went into cardio-respiratory arrest and was pronounced dead after resuscitation efforts failed. Subsequently, air collections were found in both venous and arterial circulations, including the splenoportal system. Detailed review of the clinical presentation and course, laboratory results, radiological, and pathological findings, along with a review of pertinent literature provides an explanation for the death by air embolism. Apparent inconsistent findings both radiographically and at autopsy are resolved. The mechanism of distribution of air to both systemic and splenoportal circulation is discussed. We believe this to be only the eighth case reported in English-language literature of infantile death from peripheral venous infusion. In all age groups, we find only six other cases in the English-language literature of gas found concomitantly in both the systemic and portal venous systems.

show abstract

Section: Discussionmentioning

confidence: 99%

Infant Death Due to Air Embolism from Peripheral Venous Infusion

Sowell

Lovelady

Brogdon

et al. 2006

Journal of Forensic Sciences

View full text Add to dashboard Cite

show abstract

“…Ericsson et al 103 first reported the successful use of closedchest cardiac massage in 5/5 patients with VAE occurring during neurosurgical procedures. It was initially proposed as a rapid and practical means of forcing the air lock from the right heart and into the pulmonary circulation.…”

Section: Closed-chest Cardiac Massagementioning

confidence: 99%

“…103 Resuscitative measures may include both hemodynamic and ventilatory support. It has been suggested that the successful modern management of VGE addresses not only arterial hypotension but also pulmonary hypertension.…”

Section: Supportive Measures and Oxygen Therapymentioning

confidence: 99%

Venous Air Embolism

Borromeo

2010

Surgical Intensive Care Medicine

View full text Add to dashboard Cite

DefinitionsGas embolism refers to the abnormal presence of gas within the circulatory system. It is a known complication of various surgical, therapeutic, and diagnostic procedures. It can also occur as a result of trauma. Gas embolism may be asymptomatic or may even result in immediate cardiovascular collapse. The type and severity of sequelae depend on the composition and amount of gas, the rate and location of entry, and on patient characteristics such as size, cardiopulmonary reserve, and presence of an intracardiac rightleft communication. An understanding of the etiologies and pathophysiology of gas embolism is important in order to recognize, treat, and, most importantly, prevent this potentially catastrophic complication.Gas enters the circulation when two conditions co-exist: (1) a communication between a gas source and the vascular system, and (2) a pressure gradient that favors gas entry into the vasculature. When the atmosphere is the source of gas, then this condition is termed air embolism. Gas can be entrained into open veins or venous sinuses, insufflated into traumatized vessels, or accidentally infused under pressure through indwelling venous or arterial catheters. Rarely, dissolved gas is released in blood through effervescence caused by rapid re-warming or decompression. 1 Venous (pulmonary) gas embolism (VGE) refers to gas that gains entry into the venous system and causes morbidity via its effects on the right heart and pulmonary vasculature. Systemic (arterial) gas embolism (SGE) results from gas that is propelled by the left heart and embolizes to systemic arterial beds causing ischemia and infarction. Paradoxical gas embolism (PGE) originates in the venous system and gains access to the arterial system through intracardiac defects or the pulmonary circulation.

show abstract

“…Current therapy for VAE includes 100% oxygen ventilation and cessation of nitrous oxide (where applicable) to reduce bubble size as well as withdrawal of air from central veins, the right atrium, and pulmonary arteries (4,5,(10)(11)(12)(13). In cases of massive VAE that are not responsive to these measures alone, additional maneuvers, such as the left lateral recumbent (LLR) position, either horizontal or head down, external cardiac massage, and recompression therapy, with or without hyperbaric oxygen, may be necessary (4,5,(10)(11)(12)(14)(15)(16). The recommendation of the LLR position, known as "Durant's maneuver," is based primarily on animal studies performed by Durant et al (14) beginning in 1947.…”

mentioning

confidence: 99%