Possible Pulmonary Gas Embolism Associated with Localized Thermal Therapy of the Liver

Nakayama, Ryosuke; Yano, Toshiyuki; Mizutamari, Etsuko; Ushijima, Kazuo; Terasaki, Hidenori

doi:10.1097/00000542-200307000-00035

Cited by 7 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was previously reported that 15-45% of patients with liver cirrhosis have pulmonary abnormalities, including an intrapulmonary shunt caused by pulmonary vascular dilation and arteriovenous communication [8,9]. Therefore, paradoxical emboli can occur during an air embolism even if there are no intracardiac abnormalities present in patients with hepatic cirrhosis, such as PFO [10,11]. In our case, PFO could not be identified.…”

Section: Discussionmentioning

confidence: 56%

Multiple cerebral infarction and paradoxical air embolism during hepatectomy using the Cavitron Ultrasonic Surgical Aspirator -A case report-

Lee

Kwon

Kim

et al. 2010

Korean J Anesthesiol

View full text Add to dashboard Cite

A venous air embolism and paradoxical air embolism (PAE) are serious complications in patients undergoing a hepatectomy. We report a case of PAE and cerebral infarctions in a patient undergoing a hepatic resection using a Cavitron Ultrasonic Surgical Aspirator (CUSA®). A 65-year-old woman underwent a left lobe hepatectomy. During the middle phase of the liver resection with CUSA®, there was a sudden decrease in arterial blood pressure, end-tidal carbon dioxide and SpO2. With resuscitation, intraoperative ultrasonography revealed massive air emboli in both her left and right heart, which lasted for 40 min. The hepatectomy was completed after the disappearance of the air emboli from her heart. After surgery, her mental status was stuporous. The brain CT and MRI revealed multiple acute cerebral infarctions. Finally, she died from septic shock. This case highlights the need for anesthetists and surgeons to be aware of the potential for CUSA®-related massive PAE.

show abstract

Section: Discussionmentioning

confidence: 56%

Multiple cerebral infarction and paradoxical air embolism during hepatectomy using the Cavitron Ultrasonic Surgical Aspirator -A case report-

Lee

Kwon

Kim

et al. 2010

Korean J Anesthesiol

View full text Add to dashboard Cite

show abstract

Venous air embolism and intracardiac thrombus after pressurized fibrin glue during liver surgery

Ebner

Paul

Hartmann

2011

British Journal of Anaesthesia

View full text Add to dashboard Cite

After segmental liver resection, a fibrin glue aerosol was used to stop diffuse bleeding from the liver resection site. Immediately after pressurized administration, severe hypotension and bradycardia occurred, requiring cardiopulmonary resuscitation and inotropic support. Transoesophageal echocardiography demonstrated air in both ventricles deriving from the inferior vena cava; contractility of both ventricles was markedly reduced. In addition, a 3 cm floating thrombus was detected in the right ventricle. This case demonstrates that sprayed fibrin glue can cause life-threatening air embolism and intracardiac thrombus formation in liver surgery.

show abstract

Repeated cardiac arrest caused by an air embolism during hepatic resection

Luo

Peng²,

Zhu³

et al. 2018

Medicine

View full text Add to dashboard Cite

Rationale:Although venous air embolism (VAE) during liver operation has been reported occasionally, fatal VAE in hepatic resection is uncommon. Prompt detection of VAE by transesophageal echocardiography (TEE) is crucial for effective therapy. We describe a case of fatal VAE that caused repeated cardiac arrest during hepatic resection and was confirmed by TEE.Patient concerns:A 51-year-old woman with a body weight of 50 kg underwent partial liver resection due to intrahepatic duct calculus. She had a 1-year history of intrahepatic duct calculus without cardiopulmonary disease. The operation was performed under general anesthesia combined with epidural block. When the inferior vena cava was compressed, the PetCO2 level decreased abruptly from 30 to 10 mmHg, followed by a decrease in SpO2 and the development of hypotension. Her heart rate increased with ST interval elevation on electrocardiography monitoring. Ephedrine and phenylephrine were administered immediately but had little effect. Cardiac arrest occurred.Diagnoses:Air embolism was detected by TEE.Interventions:Resuscitation was successful although cardiac arrest occurred repeatedly.Outcomes:The patient returned to consciousness 6 hours postoperatively but died of multiorgan dysfunction 10 days later.Lessons:Fatal air embolism may happen during hepatic resection. Prompt detection of VAE by TEE is crucial for effective therapy and should always be available during hepatic resection.

show abstract

Possible Pulmonary Gas Embolism Associated with Localized Thermal Therapy of the Liver

Cited by 7 publications

References 8 publications

Multiple cerebral infarction and paradoxical air embolism during hepatectomy using the Cavitron Ultrasonic Surgical Aspirator -A case report-

Multiple cerebral infarction and paradoxical air embolism during hepatectomy using the Cavitron Ultrasonic Surgical Aspirator -A case report-

Venous air embolism and intracardiac thrombus after pressurized fibrin glue during liver surgery

Repeated cardiac arrest caused by an air embolism during hepatic resection

Contact Info

Product

Resources

About