Intraoperativer Nachweis von Luftembolien und korpuskularen Embolien mit Hilfe der Pulsoximetrie und Kapnometrie

Bednarz, F.; Roewer, Norbert

doi:10.1055/s-2007-1001521

Cited by 12 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As shown by various authors (Bednarz and Roewer 1989, Watson and Stulberg 1989, HennBeilharz et al 1990), pulmonary embolism may rsult from this elevated pressure. Pressures as low as 0.8 bar lead to embolism in sheep (Wenda et al 1990).…”

Section: Discussionmentioning

confidence: 77%

The cement-canal prosthesis: A new cementation technique studied in cadaver femora

Jansson

1994

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 77%

The cement-canal prosthesis: A new cementation technique studied in cadaver femora

Jansson

1994

Acta Orthopaedica Scandinavica

View full text Add to dashboard Cite

show abstract

“…The embolaemia lasted 98 s to 30 minutes (9.6 ± 6.0 minutes). Immediately after cemented femoral prosthesis insertion 5 5 min after cemented femoral prosthesis insertion 6 10 min after cemented femoral prosthesis insertion 7 15 min after cemented femoral prosthesis insertion 8 30 min after cemented femoral prosthesis insertion Fig. 8: Changes in the mean platelet concentration in peripheral venous blood samples during total hip replacement in 18 dogs.…”

Section: Trans-oesophageal Echocardiographymentioning

confidence: 99%

“…The usefulness of trans-oesophageal echocardiography for detecting intraoperative embolaemia also was demonstrated by Bednarz and Roewer. The technique not only permits detection of intravascular or intracardiac emboli in anaesthetised patients, but also permits the estimation of the severity based on the intensity and duration of embolaemia and enables an assessment of the morphology of the emboli (7).…”

Section: Trans-oesophageal Echocardiographymentioning

confidence: 99%

Detection of Embolic Events by Capnography and Trans-oesophageal Echocardiography during Total Hip Replacement

Reindl¹,

Matis²

1998

Vet Comp Orthop Traumatol

View full text Add to dashboard Cite

SummaryTrans-oesophageal echocardiography and continuous monitoring of the partial pressure of carbon dioxide at end expiration (PETCO2) were performed in 63 dogs during total hip replacement and in three dogs during femoral stem revision. The PET CO2 usually did not change during insertion of the acetabular prosthesis, but in 17.5% of the cases, it decreased by more than 10 mmHg after insertion of the femoral prosthesis. In all of the cases, transoesophageal echocardiography revealed echogenic structures in the right side of the heart, immediately after insertion of the acetabular and of the femoral prostheses. These appeared as either numerous pinpoint echoes, which passed through the right side of the heart in a “snow flurry” like fashion, or more echogenic particles. The embolaemia, seen ultrasonographically, was categorized into one of six grades of severity. Statistical analysis showed significant positive correlations between the severity of the embolaemia and the extent of the decrease in PETCO2 (rs = 0.405; P = 0.001; n = 60), and between the severity of the embolaemia and the duration of the decrease in PETCO2 before it returned to baseline values (rs = 0.345; P = 0.007; n = 60).Trans-oesophageal echocardiography demonstrated that embolaemia was induced during cemented prosthesis insertion. It was proposed that an increase in intramedullary pressure, during insertion, forces bone marrow into the venous circulation. Bone marrow itself can constitute an embolus, but also it may activate intravascular coagulation, thus leading to thromboembolism, in addition to bone marrow embolism. Elongated particulate emboli, up to several centimetres in length, were seen on ultrasonogrammes and were thought to be, at least in part, products of intravascular coagulation. A significant decrease in the platelet concentration in peripheral venous blood, after insertion of the femoral prosthesis, was also indicative of intravascular coagulation. The extent of the impairment of gas exchange was documented by means of capnography. The significant positive correlation between the embolaemia, seen via ultrasonography, and the decrease in PETCO2 strongly suggest a causal relationship between the two variables. The rapid recovery, that occurred in most patients, is attributed to the enormous lytic ability of pulmonary tissue. Prophylactic measures include the maintenance of normovolaemia during the operations, thorough lavage of the intramedullary cavity before prosthesis insertion and steps to prevent an increase in intramedullary pressure during implantation.Using trans-oesophageal echocardiography, embolaemia in the right side of the heart was consistently detected immediately after insertion of cemented acetabular as well as cemented femoral prostheses in dogs. There was a significant correlation between the severity of the embolaemia and the decrease in carbon dioxide at end expiration (PETCO2) after femoral prosthesis insertion.

show abstract

“…Aufgrund theoretischer Überlegungen und der vorliegenden Literatur [1,2,3,13,19,20] konnten thrombembolische Ereignisse und Flüssigkeitseinschwemmung mit konsekutiver kardiopulmonaler Dekompensation oder Elektrolytentgleisungen als die wahrscheinlichsten Gefahrenmomente charakterisiert werden. Im Rahmen der operativen Maßnahmen erfolgte eine Abschätzung potentieller Gefahren.…”

unclassified

“…Dabei wurde Umgebungsluft Teil des Wasserstrahlabrasivgemisches. Das Auftreten von Embolien bei der Implantation von Endoprothesen durch Einschwemmung von Markraumbestandteilen wurde bereits in einer Vielzahl klinischer und experimenteller Studien untersucht [1,3]. In der Literatur sind bereits Einzelfälle von Luftembolie im Rahmen von Wasserstrahlanwendungen bei der Bearbeitung von parenchymatösen Organen, insbesondere der Leber, beschrieben [2,20].…”

unclassified

Evaluation verfahrensspezifischer Risikopotentiale der Wasserabrasivstrahl – Osteotomie in-vivo / Evaluation of potential risks of abrasive water jet osteotomy in-vivo

Kuhlmann¹,

Pude²,

Bishup³

et al. 2005

Biomedizinische Technik/Biomedical Engineering

View full text Add to dashboard Cite

Since the 80's the water jet scalpel is an established tool in some surgical fields. It is used in particular in visceral surgery for preparation of parenchymatous organs. By the addition of biocompatible abrasives, this technique is able to effectively machine hard biological tissues. Free defined cutting geometries can be realised in a non contact process. Therewith this method has crucial advantages compared to conventional osteotomy techniques and gives new impulses to the development in endoprosthetics and correction osteotomies of hollow bones. In the presented work the new developed abrasive water injection jet (AWIJ) was used the first time for in-vivo osteotomies. Aim of this study was the detection of potential thrombembolic effects and wash in effects of the cutting fluid. Hollow bones of the fore and hind leg of 20 house pigs were treated with the new cutting technique. Intraoperative documentation of relevant vital parameters was performed by a multi monitoring system. Thrombembolic effects during the osteotomy were detected by transthoracic Doppler ultrasonography and transesophagale echocardiography. The hollow bones were prepared in consideration of the vascularisation's protection especially in respect to the venous flow. Thrombembolic effects with temporary haemodynamic respectively respiratory consequences could be detected exclusively by using the so called "3-component jet", which consists of 90 vol % of air. The usage of an abrasive suspension enables the airfree dosing of dry soluable abrasives. Thrombembolic effects could not be monitored in this case. Intramedullary fluid in-wash effects as well as resulting electrolytic disorders could not be proven. For abrasive waterjet osteotomies with 3 component jet a relevant risk of thrombembolic effects could be shown. This knowledge has also to be considered for abdominal and neurosurgical applications in the future. Due to the usage of an abrasive suspension this risk can fully be avoided.

show abstract

Intraoperativer Nachweis von Luftembolien und korpuskularen Embolien mit Hilfe der Pulsoximetrie und Kapnometrie

Cited by 12 publications

References 19 publications

The cement-canal prosthesis: A new cementation technique studied in cadaver femora

The cement-canal prosthesis: A new cementation technique studied in cadaver femora

Detection of Embolic Events by Capnography and Trans-oesophageal Echocardiography during Total Hip Replacement

Evaluation verfahrensspezifischer Risikopotentiale der Wasserabrasivstrahl – Osteotomie in-vivo / Evaluation of potential risks of abrasive water jet osteotomy in-vivo

Contact Info

Product

Resources

About