The effects of experimental venous carbon dioxide embolization on hemodynamic and respiratory variables

Abstract

Negative changes in cardiopulmonary physiology persisted for at least 4 h after a single intravenous CO2 injection, in spite of this gas being highly soluble in blood. This is a more prolonged influence of CO2 embolization than previously described. Extensive monitoring for early detection of an embolization may be recommended to limit morbidity in patients undergoing laparoscopic liver surgery.

Intracardiac Transvenous Echocardiography Is Superior to Both Precordial Doppler and Transesophageal Echocardiography Techniques for Detecting Venous Air Embolism and Catheter-Guided Air Aspiration

“…First, we used swine but this is an established approach in VAE trials. 14,49,50 Second, the exquisite sensitivity of ICE might cause false-positive results, especially with IV fluids being administered. As this was not investigated in our study, the influence of IV fluids on the correct detection of VAE using ICE needs to be evaluated in further trials.…”

“…(Anesth Analg 2008;106: [45][46][47][48][49][50][51][52][53][54] Venous air embolism (VAE) is a frequent and potentially fatal complication during surgery with patients in the sitting position, and may occur whenever venous pressure at the site of surgery is near or below atmospheric pressure. [1][2][3] Air entrainment can present as either acute massive air embolism, evoking immediate hemodynamic compromise, or as persistent low volume VAE, which may be prodromal to massive VAE.…”

Laparoscopic parenchymal division of the liver in a porcine model: comparison of the efficacy and safety of three different techniques

“…In an earlier experimental study, we found changes in arterial blood gases that lasted 4 h after an experimental embolization in a porcine model. In contrast, EtCO 2 was back to preembolic values after less than 30 min [24]. Therefore, we consider monitoring with TEE and EtCO 2 appropriate methods for detecting emboli, and we consider continuous monitoring of blood gases a superior means of identifying emboli of clinical relevance.…”

Cardiac air transit following venous air embolism and right ventricular air aspiration*

“…Although we used swine, this is an established model in venous air embolism trials [13,21,30,31]. Due to the views used to visualise the right atrium, right ventricle and pulmonary artery, the pulmonary artery appearance time could not be measured simultaneously.…”