Venous air embolism during surgery, especially cesarean delivery

Journal of Korean Medical Science

Volumn 23, Issue 5, 2008, Pages 753-761

  Chang, Seok Kim ^a   Liu, Jia ^b   Kwon, Ja Young ^a   Seo, Kyung Shin ^a   Ki, Jun Kim ^a,b  

^a Yonsei University College of Medicine   (South Korea)

^b UNIVERSITY OF CALIFORNIA   (United States)

Author keywords

Cesarean delivery; Venous air embolism

Indexed keywords

AIR EMBOLISM; CESAREAN SECTION; DOPPLER FLOWMETRY; ECHOGRAPHY; FEMALE; HUMAN; METHODOLOGY; OBSTETRIC ANESTHESIA; OBSTETRICS; PATIENT MONITORING; PEROPERATIVE COMPLICATION; PREGNANCY; REVIEW; RISK FACTOR; TRANSESOPHAGEAL ECHOCARDIOGRAPHY;

ANESTHESIA, OBSTETRICAL; CESAREAN SECTION; ECHOCARDIOGRAPHY, TRANSESOPHAGEAL; EMBOLISM, AIR; FEMALE; HUMANS; INTRAOPERATIVE COMPLICATIONS; MONITORING, INTRAOPERATIVE; OBSTETRICS; PREGNANCY; RISK FACTORS; ULTRASONOGRAPHY, DOPPLER;

EID: 56049121988     PISSN: 10118934     EISSN: 15986357     Source Type: Journal    
DOI: 10.3346/jkms.2008.23.5.753     Document Type: Review

References (83)

1. Mommerot A, Perrault LP. Carbon dioxide embolism induced by endoscopic saphenous vein harvesting during coronary artery bypass grafting. J Thorac Cardiovasc Surg 2006; 132: 1502.
2. Staffieri F, Lacitignola L, De Siena R, Crovace A. A case of spontaneous venous embolism with carbon dioxide during laparoscopic surgery in a pig. Vet Anaesth Analg 2007; 34: 63-6.
3. Kama NA. Influence of nitrous oxide anesthesia on venous gas embolism with carbon dioxide and helium during pneumoperitoneum. Surg Endosc 2001; 15: 1237-8.
4. Cottin V, Viale JP, Bouffard Y, Delafosse B. Severe nitrous oxide embolism during venous stripping. Intensive Care Med 1997; 23: 1287-8.
5. Boussuges A, Blanc F, Carturan D. Hemodynamic changes induced by recreational scuba diving. Chest 2006; 129: 1337-43.
6. Risberg J, Englund M, Aanderud L, Eftedal O, Flook V, Thorsen E. Venous gas embolism in chamber attendants after hyperbaric exposure. Undersea Hyperb Med 2004; 31: 417-29.
7. Mitchell SJ, Benson M, Vadlamudi L, Miller P. Cerebral arterial gas embolism by helium: an unusual case successfully treated with hyperbaric oxygen and lidocaine. Ann Emerg Med 2000; 35: 300-3.
8. Papadopoulos G, Kuhly P, Brock M, Rudolph KH, Link J, Eyrich K. Venous and paradoxical air embolism in the sitting position. A prospective study with transoesphageal echocardiography. Acta Neurochir (wien) 1994; 126: 140-3.
9. Losasso TJ, Muzzi DA, Dietz NM, Cucchiara RF. Fifty percent nitrous oxide does not increase the risk of venous air embolism in neurosurgical patients operated upon in the sitting position. Anesthesiology 1992; 77: 21-30.
10. Albin MS, Carroll RG, Maroon JC. Clinical considerations concerning detection of venous air embolism. Neurosurgery 1978; 3: 380-4.
11. Michel R. Air embolism in hip surgery. Anaesthesia 1980; 35: 858-62.
12. Schmandra TC, Mierdl S, Bauer H, Gutt C, Hanisch E. Transoesophageal echocardiography shows high risk of gas embolism during laparoscopic hepatic resection under carbon dioxide pneumoperitoneum. Br J Surg 2002; 89: 870-6.
13. Maddukuri P, Downey BC, Blander JA, Pandian NG, Patel AG. Echocardiographic diagnosis of air embolism associated with central venous catheter placement: case report and review of the literature. Echocardiography 2006; 23: 315-8.
14. Rabe C, Balta Z, Wüllner U, Heller J, Hammerstingl C, Tiemann K, Sommer T, Schepke M, Fischer HP, Sauerbruch T. Biliary metal stents and air embolism: a note of caution. Endoscopy 2006; 38: 648-50.
15. Cuvelier A, Muir JF. Images in clinical medicine: venous air embolism. N Engl J Med 2006; 354: e26.
16. Ho AM, Ling E. Systemic air embolism after lung trauma. Anesthesiology 1999; 90: 564-75.
17. Southern DA, Arramovic J, Fitzsimmons K. Air embolism following abdominal stab-wound. Anaesth Intensive Care 1996; 24: 623.
18. Cormack JR. The entrance of air by the open mouths of the veins, considered as cause of danger and death after parturition. London Med J 1850; 2: 928.
19. Durant TM, Long J, Oppenheimer MJ. Pulmonary venous air embolism. Am Heart J 1947; 33: 269-81.
20. Waldrop GS. Fatal air embolism during term labor and the puerperium. Obstet Gynecol 1953; 1: 454-9.
21. Merrill DG. Samuels SI, Silverberg GD. Venous air embolism of uncertain etiology. Anesth Analg 1982; 61: 65-6.
22. Younker D, Rodriguez V, Kavanagh J. Massive air embolism during cesarean section. Anesthesiology 1986; 65: 77-9.
23. Fong J, Gadalla F, Gimbel AA. Precordial Doppler diagnosis of haemodynamically compromising air embolism during caesarean section. Can J Anaesth 1990; 37: 262-4.
24. Lang S. Precordial Doppler diagnosis of haemodynamically compromising air embolism during caesarean section. Can J Anaesth 1991; 38: 255-6.
25. Mushkat Y, Luxman D, Nachum Z, David MP, Melamed Y. Gas embolism complicating obstetric or gynecologic procedures. Case reports and review of the literature. Eur J Obstet Gynecol Reprod Biol 1995; 63: 97-103.
26. Epps SN, Robbins AJ, Marx GF. Complete recovery after near-fatal venous air embolism during cesarean section. Int J Obstet Anesth 1998; 7: 131-3.
27. Kostash MA, Mensink F. Lethal air embolism during cesarean delivery for placenta previa. Anesthesiology 2002; 96: 753-4.
28. Nims M, Hallonguist H, Camann W. Coronary arterial air embolus occurring during cesarean delivery. Int J Obstet Anesth 2006; 15: 166-9.
29. Malinow AM, Naulty JS, Hunt CO, Datta S, Ostheimer GW. Precordial ultrasonic monitoring during cesarean delivery. Anesthesiology 1987; 66: 816-9.
30. Fong J, Gadalla F, Pierri MK, Druzin M. Are Doppler-detected emboli during cesarean section air emboli? Anesth Analg 1990; 71: 254-7.
31. Karuparthy VR, Downing JW, Husain FJ, Knape KG, Blanchard J, Solomon D. Incidence of venous air embolism during cesarean section is unchanged by the use of a 5 to 10o head-up tilt. Anesth Analg 1989; 69: 620-3.
32. Fong J, Gadalla F, Druzin M. Venous emboli occurring caesarean section: the effect of patient position. Can J Anaesth 1991; 38: 191-5.
33. Handler JS, Bromage PR. Venous air embolism during cesarean delivery. Reg Anesth 1990; 15: 170-3.
34. Vartikar JV, Johnson MD, Datta S. Precordial Doppler monitoring and pulse oximetry during cesarean delivery: detection of venous air embolism. Reg Anesth 1989; 14: 145-8.
35. Lew TW, Tay DH, Thomas E. Venous air embolism during cesarean section: more common than previously thought. Anesth Analg 1993; 77: 448-52.
36. Kaunitz AM, Hughes JM, Grimes DA, Smith JC, Rochat RW, Kafrissen ME. Causes of maternal mortality in the united states. Obstet Gynecol 1985; 65: 605-12.
37. Maroon JC, Goodman JM, Horner TG, Campbell RL. Detection of minute venous air emboli with ultrasound. Surg Gynecol Obstet 1968; 127: 1236-8.
38. Butler BD, Hills BA. The lung as a filter for microbubbles. J Appl Physiol 1979; 47: 537-43.
39. Butler BD, Hills BA. Transpulmonary passage of venous air emboli. J Appl Physiol 1985; 59: 543-7.
40. Nelson PK. Pulmonary gas embolism in pregnancy and the puerperium. Obstet Gynecol Surv 1960; 15: 449-81.
41. Hlastala MP, Bobertson HT, Ross BK. Gas exchange abnormalities produced by venous gas emboli. Respir Physiol 1979; 36: 1-17.
42. Deem S, McKinney S, Polissar NL, Hedges RG, Swenson ER. Hemodilution during venous gas embolization improves gas exchange, without altering V(A)/Q or pulmonary blood flow distributions. Anesthesiology 1999; 91: 1861-72.
43. Souders JE. Pulmonary air embolism. J Clin Monit Comput 2000; 16: 375-83.
44. Verstappen FT, Bernards JA, Kreuzer F. Effects of pulmonary gas embolism on circulation and respiration in the dog. IV. Origin of arterial hypoxemia during pulmonary gas embolism. Pflugers Arch 1977; 370: 71-5.
45. Wang D, Ki MH, Hsu K, Shen CY, Chen HI, Lin YC. Air embolism induced lung injury in isolated rat lungs. J Appl Physiol 1992; 72: 1235-42.
46. Albertine KH, Wiener-Kronish JP, Koike K, Staub NC. Quantification of damage by air emboli to lung microvessels in anesthetized sheep. J Appl Physiol 1984; 57: 1360-8.
47. Ohkuda K, Nakahara K, Binder A, Staub NC. Venous air emboli in sheep: reversible increase in lung microvascular permeability. J Appl Physiol 1981; 51: 887-94.
48. Furuya H, Suzuki T, Okumura F, Kishi Y, Uefuji T. Detection of air embolism by transesophageal echocardiography. Anesthesiology 1983; 58: 124-9.
49. Milani RV, Lavie CJ, Gilliland YE, Cassidy MM, Bernal JA. Overview of transesophageal echocardiography for the chest physician. Chest 2003; 124: 1081-9.
50. Gibby GL. Precordial Doppler is not obsolete for venous air embolism monitoring. Anesthesiology 1988; 68: 829.
51. Gildenberg PL, O'Brien RP, Britt WJ, Frost EA. The efficacy of Doppler monitoring for the detection of venous air embolism. J Neurosurg 1981; 54: 75-8.
52. Schubert A, Deogaonkar A, Drummond JC. Precordial Doppler probe placement for optimal detection of venous air embolism during craniotomy. Anesth Analg 2006; 102: 1543-7.
53. Matjasko J, Petrozza P, Mackenzie CF. Sensitivity of end-tidal nitrogen in venous air embolism detection in dogs. Anesthesiology 1985; 63: 418-23.
54. Russell GB, Richard RB, Snider MT. Detection of venous air embolism in dogs by emission spectrometry. J Clin Monit 1990; 6: 18-23.
55. Drummond JC, Prutow RJ, Scheller MS. A comparison of the sensitivity of pulmonary artery pressure, end-tidal carbon dioxide, and end-tidal nitrogen in the detection of venous air embolism in the dog. Anesth Analg 1985; 64: 668-92.
56. Matjasko MJ, Hellman J, Mackenzie CF. Venous air embolism, hypotension, and end-tidal nitrogen. Neurosurgery 1987; 21: 378-82.
57. Losasso TJ, Black S, Muzzi DA, Michenfelder JD, Cucchiara RF. Detection and hemodynamic consequences of venous air embolism. Does nitrous oxide make a difference? Anesthesiology 1992; 77: 148-52.
58. Burton A, Camann W. Electrocardiographic changes during cesarean section: a review. Int J Obstet Anesth 1996; 5: 47-53.
59. Mathew JP, Fleisher LA, Rinehouse JA, Sevarino FB, Sinatra RS, Nelson AH, Prokop EK, Rosenbaum SH. ST segment depression during labor and delivery. Anesthesiology 1992; 77: 635-41.
60. Williamson JA, Helps SC, Westhorpe RN, Mackay P. Crisis management during anaesthesia: embolism. Qual Saf Health Care 2005; 14: e17.
61. Giebler R, Kollenberg B, Pohlen G, Peters J. Effect of positive end-expiratory pressure on the incidence of venous air embolism and on the cardiovascular response to the sitting position during neurosurgery. Br J Anaesth 1998; 80: 30-5.
62. Zasslow MA, Pearl RG, Larson CP, Silverberg G, Shuer LF. PEEP does not affect left atrial-right atrial pressure difference in neurosurgical patients. Anesthesiology 1988; 68: 760-3.
63. Clarke NR, Timperley J, Kelion AD, Banning AP. Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. Eur J Echocardiogr 2004; 5: 176-81.
64. Meyer PG, Cuttaree H, Charron B, Jarreau MM, Perie AC, Sainte-Rose C. Prevention of venous air embolism in paediatric neurosurgical procedures performed in the sitting position by combined use of MAST suit and PEEP. Br J Anaesth 1994; 73: 795-800.
65. Butler BD, Conkin J, Luehr S. Pulmonary hemodynamics, extravascular lung water and residual gas bubbles following low dose venous gas embolism in dogs. Aviat Space Environ Med 1989; 60: 1178-82.
66. Martin JT. Neuroanesthetic adjuncts for surgery in the sitting position. II. The antigravity suit. Anesth Analg 1970; 49: 588-93.
67. Tinker JH, Vandam LD. How effective is the G suit in neurosurgical operations? Anesthesiology 1972; 36: 609-11.
68. Oppenheimer MJ, Durant TM, Lynch P. Body position in relation to venous air embolism and the associated cardiovascular-respiratory changes. Am J Med Sci 1953; 225: 362-73.
69. Geissler HJ, Allen SJ, Mehlhorn U, Davis KL, Morris WP, Butler BD. Effect of body repositioning after venous air embolism. An echocardiographic study. Anesthesiology 1997; 86: 710-7.
70. Butler BD, Luehr S, Katz J. Venous gas embolism: time course of residual pulmonary intravascular bubbles. Undersea Biomed Res 1989; 16: 21-9.
71. Kyttä J, Tanskanen P, Randell T. Comparison of the effects of controlled ventilation with 100% oxygen, 50% oxygen in nitrogen, and 50% oxygen in nitrous oxide on responses to venous air embolism in pigs. Br J Anaesth 1996; 77: 658-61.
72. Roberts MW, Mathiesen KA, Ho HS, Wolfe BM. Cardiopulmonary responses to intravenous infusion of soluble and relatively insoluble gases. Surg Endosc 1997; 11: 341-6.
73. Knüttgen D, Stölzle U, Köning W, Müller MR, Doehn M. Air embolism in the sitting position. Oxygen/nitrogen versus oxygen/laughing gas. Anaesthesist 1989; 38: 490-7.
74. Adornato DC, Gildenberg PL, Ferrario CM, Smart J, Frost EA. Pathophysiology of intravenous air embolism in dogs. Anesthesiology 1978; 49: 120-7.
75. Bowdle TA, Artru AA. Positioning the air aspiration pulmonary artery catheter introducer sheath by intravascular electrocardiography. Anesthesiology 1988 ; 69: 276-9.
76. Calvin JE Jr. Acute right heart failure: pathophysiology, recognition, and pharmacological management. J Cardiothorac Vasc Anesth 1991; 5: 507-13.
77. Vlahakes GJ, Turley K, Hoffman JI. The pathophysiology of failure in acute right ventricular hypertension: hemodynamic and biochemical correlations. Circulation 1981; 63: 87-95.
78. Angle MR, Molloy DW, Penner B, Jones D, Prewitt RM. The cardiopulmonary and renal hemodynamic effects of norepinephrine in canine pulmonary embolism. Chest 1989; 95: 1333-7.
79. Monrad ES, Baim DS, Smith HS, Lanoue AS. Milrinone, dobutamine, and nitroprusside: comparative effects on hemodynamics and myocardial energetics in patients with severe congestive heart failure. Circulation 1986; 73: III168-74.
80. Jardin F, Genevray B, Brun-Ney D, Margairaz A. Dobutamine: a hemodynamic evaluation in pulmonary embolism shock. Crit Care Med 1985; 13: 1009-12.
81. Nayagam J, Ho KM, Liang J. Fatal systemic air embolism during endoscopic retrograde cholangio-pancreatography. Anaesth Intensive Care 2004; 32: 260-4.
82. Murphy BP, Harford FJ, Cramer FS. Cerebral air embolism resulting from invasive medical procedures. Treatment with hyperbaric oxygen. Ann Surg 1985; 201: 242-5.
83. Russell GB, Snider MT, Richard RB, Loomis JL. Venous air emboli with 15N2: pulmonary excretion and physiologic responses in dogs. Undersea Biomed Res 1991; 18: 37-45.