Fatal venous air embolism in a cat undergoing dental extractions

Gunew, M.; Marshall, R. L.; Lui, M. W.; Astley, Cai

doi:10.1111/j.1748-5827.2008.00606.x

Cited by 23 publications

(17 citation statements)

References 15 publications

(31 reference statements)

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“…Im akuten Zustand ist dies aufgrund der Unkoordiniertheit der Tiere und der bestehenden Ataxie als zu gefährlich einzustufen. Eine computertomographische Untersuchung des Gehirns war aufgrund der notwendigen Sedation und Narkose in den vorliegenden Fällen ebenso als zu komplikationsreich anzusehen (Walsh et al 2005, Gunew et al 2008, Pellegrini-Masini et al 2009, Heng et al 2014, Suri et al 2014, Reith et al 2015. Zusammenhang mit der vorangegangen Thorakoskopie nicht auszuschließen, allerdings wurden in der Literatur bei ähn-lichen Eingriffen solche Komplikationen nicht beobachtet (Scharner 2012).…”

Section: Patientunclassified

“…Aufgrund der Ähnlichkeit der Symptome mit den Beschreibungen in der Literatur in unmittelbarem zeitlichen Zusammenhang mit dem Auffinden einer nicht verschlossenen Katheterverbindung, kann eine Luftembolie als Ursache jedoch vermutet werden (Bradbury et al 2005, Holbrook et al 2007, Caporelli et al 2009, Pellegrini-Masini et al 2009 (Walsh et al 2005, Gunew et al 2008, Pellegrini-Masini et al 2009). …”

Section: Patientunclassified

“…Eine Möglichkeit ist eine hyperbare Sauerstofftherapie zur Sicherstellung der ausreichenden Oxygenierung des Körpers (Pellegrini-Masini et al 2009, Tekle et al 2013 (Bradbury et al 2005, Holbrook et al 2007, Sams und Hofmeister 2008, Caporelli et al 2009, Pellegrini-Masini et al 2009). In der Kleintiermedizin und Humanmedizin hingegen wird häufiger ein fataler Ausgang berichtet (Walsh et al 2005, Gunew et al 2008, Reith et al 2015. …”

Section: Patientunclassified

“…Dabei handelt es sich um den Eintritt von Luft in das Gefäßsystem, wenn eine Verbindung zwischen der Umgebungsluft und dem Kreislaufsystem besteht. Dies kann zum Beispiel durch Verletzungen und Operationen an großen Gefäßen oder iatrogen durch Venenkatheter, Infusionsleitungen oder Spritzen auftreten (Gabriel 2008, Gunew et al 2008. Diese in der Humanmedizin bekannte Problematik kann schwerwiegende Folgen durch zerebrale Hypoxien und Minderperfusion von Organen verursachen (Lewandowski und Lewandowski 2003, Tuppatsch 2008.…”

Section: Introductionunclassified

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Clinical presentation and short-term outcome in two horses with suspected air embolism

Gittel¹,

Delling²,

Brehm³

et al. 2016

PHK

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Complications associated with intravenous catheters have been reported frequently and are not only limited to thrombophlebitis of the respective vessel. There are some reports of air embolism in small and large animals described in the literature. The source of air aspiration can be traumatic, iatrogenic during surgeries and also related to venous catheters. Not only the reason for air aspiration, but also the consequences differ between human, small animals and horses. This present article describes the clinical signs, treatment and short-term outcome of two horses with suspected venous air embolism but with different underlying diseases. Both horses exhibited a sudden onset of cardiovascular shock and periods of neurological disorder during their hospitalization. One horse also showed colic symptoms. In both horses an inadvertently opened venous catheter was found at the onset of unexpected symptoms. Therefore, air embolism due to air aspiration by the open venous access might be possible. In air embolism, a decreased perfusion and reduced oxygen delivery are potential sequelae. An impairment of the cardiovascular system with subsequent cerebellar hypoperfusion and embolism might be an explanation for the observed clinical signs. These were tachycardia, delayed capillary refill time and excitement. Furthermore, ataxia, seizures and blindness was observed. Intensity and duration of clinical signs differed between both horses. Following supportive treatment, both horses were discharged from hospital in a good condition. The exact amount of air leading to clinical signs is not exactly known despite different studies aiming at finding a lethal dose. However, rate and amount of air aspiration, as well as body weight and health status of the patient may also have an effect on occurrence of overt clinical signs of venous air embolism. Due to the lack of specific treatment options, symptomatic therapy has been performed. This includes intravenous fluid administration for cardiovascular stabilization and anti-inflammatory treatment. Additionally, nasal oxygen insufflations may increase tissue oxygenation. Furthermore, neuroprotectiv treatment, like dexamethason, might also be advantageous regarding the pathophysiology of venous and cerebellar air embolism. Antithrombotic treatment can be initiated in order to avoid formation of thrombus following capillary perfusion disturbances in the circulation. Diagnostic proof is lacking in both cases, however, presence of an open venous catheter and the observed clinical signs lead to the suspected diagnosis of venous air embolism. Venous air embolism seems to have a low incidence in equine medicine, and the exact dimension of clinical signs may not always be obvious. Close attention should be paid at infusion lines, air within syringes, disconnection of catheters and their extensions and catheter caps. Problems may occur due to manipulations by the horse itself or due to improper handling by the attending veterinarian. Several medical devices aim at reducing the risk of air aspi...

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Section: Patientunclassified

Section: Introductionunclassified

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Clinical presentation and short-term outcome in two horses with suspected air embolism

Gittel¹,

Delling²,

Brehm³

et al. 2016

PHK

View full text Add to dashboard Cite

show abstract

“…[19][20][21] Therefore, caution must be exercised when using the airwater syringe or high-speed handpieces, particularly in close proximity to vessels whose integrity may have been compromised by trauma from the extraction procedure.…”

Section: Air Embolismmentioning

confidence: 99%