Venous Air Embolism Publications (2451)


Venous Air Embolism Publications

ASAIO J 2017 Jan 19. Epub 2017 Jan 19.
* Department of Internal Medicine V - Pneumology, Allergology and Critical Care Medicine, Saarland University Medical Center, Homburg, Germany † Department of Thoracic and Cardiac Surgery, Division of Cardiovascular Perfusion, Saarland University Medical Center, Homburg, Germany ‡ Maquet Clinical Concepts, MaquetGetinge Group, Rastatt, Germany § Department of Anaesthesiology, University Hospital of Würzburg, Würzburg, Germany ¶ Kliniken Maria Hilf, Division of Cardiology, Electrophysiology and Critical Care Medicine, Mönchengladbach, Germany.

Extracorporeal carbon dioxide removal (ECCO2R) is increasingly considered a viable therapeutic approach in the management of hypercapnic lung failure in order to avoid intubation or to allow lung-protective ventilator settings. This study aimed to analyze efficacy and safety of a minimal-invasive ECCO2R device, the Homburg lung. The Homburg lung is a pump-driven system for veno-venous ECCO2R with ¼" tubing and a 0. Read More

8 m surface oxygenator. Vascular access is usually established via a 19F/21cm bilumen cannula in the right internal jugular vein. For this work we screened patient registries from two German centers for patients who underwent ECCO2R with the Homburg lung due to hypercapnic lung failure since 2013. Patients who underwent ECMO prior to ECCO2R were excluded. Patients who underwent ECCO2R more than one time were only included once. In total, 24 patients (age 53.86 ± 12.49 years. 62.5% male) were included in the retrospective data analysis. Ventilatory failure occurred due to COPD (50%), cystic fibrosis (16.7%), ARDS (12.5%), and other origins (20.8%). The system generated a blood flow of 1.18 ± 0.23 lpm. Sweep gas flow was 3.87 ± 2.97 lpm. Within four hours, PaCO2 could be reduced significantly from 82.05 ± 15.57 mmHg to 59.68 ± 12.27 mmHg, pH thereby increasing from 7.23 ± 0.10 to 7.36 ± 0.09. Cannulation-associated complications were transient arrhythmia (1/24 patients) and air embolism (1/24). Fatal complications did not occur. In conclusion, the Homburg Lung provides effective carbon dioxide removal in hypercapnic lung failure. The cannulation is a safe procedure with complication rates comparable to those in central venous catheter implantation.

Am. J. Clin. Oncol.
Am J Clin Oncol 2017 Feb;40(1):94-105
*Surgical Outcomes Analysis & Research †Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Intensive Care Med
Intensive Care Med 2017 Jan 19. Epub 2017 Jan 19.
Department of Anesthesia and Intensive Care, Sultan Qaboos University Hospital, P.O. Box 123, PC 38, Al Khod, Muscat, Oman.
Gynecol. Obstet. Invest.
Gynecol Obstet Invest 2017 Jan 4. Epub 2017 Jan 4.
Department of Cardiovascular Sciences, KU Leuven, Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium.
Case Rep Med
Case Rep Med 2016 27;2016:8236845. Epub 2016 Nov 27.
Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA.

OBJECTIVE The objective of this study was to analyze the incidence of the primary complications related to positioning or surgery and their impact on neurological outcome in a consecutive series of patients undergoing elective surgery in the semisitting position. METHODS The authors prospectively collected and retrospectively analyzed data from adult patients undergoing elective surgery in the semisitting position for a cranial disease. Patients were managed perioperatively according to a standard institutional protocol, a standardized stepwise positioning, and surgical maneuvers to decrease the risk of venous air embolism (VAE) and other complications. Read More

Intraoperative and postoperative complications were recorded. Neurointensive care unit (NICU) length of stay (LOS) and hospital LOS were the intermediate endpoints. Neurological outcome was the primary endpoint as determined by the modified Rankin scale (mRS) score at 6 months after surgery. RESULTS Four hundred twenty-five patients were included in the analysis. VAE occurred in 90 cases (21%) and it made no significant statistical difference in NICU LOS, hospital LOS, and neurological outcome. No complication was directly related to the semisitting position, although 46 patients (11%) experienced at least 1 surgery-related complication and NICU LOS and hospital LOS were significantly prolonged in this group. Neurological outcome was significantly worse for patients with complications (p < 0.0001). CONCLUSIONS Even in the presence of intraoperative VAE, the semisitting position was not related to an increased risk of postoperative deficits and can represent a safe additional option for the benefit of specific surgical and patient needs.

BMJ Case Rep
BMJ Case Rep 2016 Dec 5;2016. Epub 2016 Dec 5.
Department of Internal Medicine, St Mary's Hospital, Waterbury, Connecticut, USA.