BACKGROUND Venous air embolism(VAE)is a potentially lethal condition,with a reported incidence rate of about 0.13%,and the true incidence may be higher since many VAE are asymptomatic.The current treatments for VAE in...BACKGROUND Venous air embolism(VAE)is a potentially lethal condition,with a reported incidence rate of about 0.13%,and the true incidence may be higher since many VAE are asymptomatic.The current treatments for VAE include Durant's maneuver,aspiration and removal of air through venous catheters,and hyperbaric oxygen therapy.For critically ill patients,use of cardiotonic drugs and chest compressions remain useful strategies.The wider availability of extracorporeal membrane oxygenation(ECMO)has brought a new option for VAE patients.CASE SUMMARY A 53-year-old female patient with VAE presented to the emergency clinic due to abdominal pain with fever for 1 d and unconsciousness for 2 h.One day ago,the patient suffered from abdominal pain,fever,and diarrhea.She suddenly became unconscious after going to the toilet during the intravenous infusion of ciprofloxacin 2 h ago,accompanied by nausea and vomiting,during which a small amount of gastric contents were discharged.She was immediately sent to a local hospital,where cranial and chest computed tomography showed bilateral pneumonia as well as accumulated air visible in the right ventricle and pulmonary artery.The condition deteriorated despite endotracheal intubation,rehydration,and other treatments,and the patient was then transferred to our hospital.Veno-arterial ECMO was applied in our hospital,and the patient's condition gradually improved.The patient was successfully weaned from ECMO and extubated after two days.CONCLUSION ECMO may be an important treatment for patients with VAE in critical condition.展开更多
Background:Deep brain stimulation (DBS) surgery is usually performed with the patients located in a half-sitting position.Therefore,complications associated with such position accompany,such as venous air embolism (VA...Background:Deep brain stimulation (DBS) surgery is usually performed with the patients located in a half-sitting position.Therefore,complications associated with such position accompany,such as venous air embolism (VAE),et al.However,because the patients are fully conscious during the surgery,they may have observable manifestations related to the complications that are otherwise inconspicuous in generally anesthetic surgeries.Thus,we designed this study to investigate the intraoperative manifestations of the potentially dangerous complication of VAE in the DBS surgery.Methods:The medical records of a series of 705 consecutive patients who underwent DBS surgery in our hospital have been retrospectively reviewed.The clinical features,intraoperative manifestations and treatment of these patients were analyzed for evidence of VAE.The correlation between the cough intensity and other clinical features were investigated.Results:Evidence of VAE were found in 16 patients.Statistical analyses showed that severe cough is associated with greater age (p =0.045),longer coughing time (p =0.001),more intensive tremor (p =0.032),more complaints (p =0.036),greater influences (p =0.009),more treatment (p =0.003) and longer hospitalization (p =0.003).Conclusions:Intraoperative intense and unremitting cough may be a noticeable indicator of possible VAE.Early recognition and effective management are essential to prevent unfavorable outcomes in such cases.展开更多
A 36-year-old woman suffered meningioma in her right cerebellopontine angle.Air embolisms often complicate sitting-position surgeries.Because TEE guides the localization of central venous catheters and promptly locate...A 36-year-old woman suffered meningioma in her right cerebellopontine angle.Air embolisms often complicate sitting-position surgeries.Because TEE guides the localization of central venous catheters and promptly locates air embolisms promptly enough for effective treatment,TEE is an effective monitoring method for sitting-position surgeries.展开更多
基金Construction and Application of Management Program for Prevention and Treatment of Inpatients with Venous Thromboembolism,No.WFWSJK-2022-111and Shandong Provincial Medical and Health Science and Technology Development Program,No.202103050856.
文摘BACKGROUND Venous air embolism(VAE)is a potentially lethal condition,with a reported incidence rate of about 0.13%,and the true incidence may be higher since many VAE are asymptomatic.The current treatments for VAE include Durant's maneuver,aspiration and removal of air through venous catheters,and hyperbaric oxygen therapy.For critically ill patients,use of cardiotonic drugs and chest compressions remain useful strategies.The wider availability of extracorporeal membrane oxygenation(ECMO)has brought a new option for VAE patients.CASE SUMMARY A 53-year-old female patient with VAE presented to the emergency clinic due to abdominal pain with fever for 1 d and unconsciousness for 2 h.One day ago,the patient suffered from abdominal pain,fever,and diarrhea.She suddenly became unconscious after going to the toilet during the intravenous infusion of ciprofloxacin 2 h ago,accompanied by nausea and vomiting,during which a small amount of gastric contents were discharged.She was immediately sent to a local hospital,where cranial and chest computed tomography showed bilateral pneumonia as well as accumulated air visible in the right ventricle and pulmonary artery.The condition deteriorated despite endotracheal intubation,rehydration,and other treatments,and the patient was then transferred to our hospital.Veno-arterial ECMO was applied in our hospital,and the patient's condition gradually improved.The patient was successfully weaned from ECMO and extubated after two days.CONCLUSION ECMO may be an important treatment for patients with VAE in critical condition.
文摘Background:Deep brain stimulation (DBS) surgery is usually performed with the patients located in a half-sitting position.Therefore,complications associated with such position accompany,such as venous air embolism (VAE),et al.However,because the patients are fully conscious during the surgery,they may have observable manifestations related to the complications that are otherwise inconspicuous in generally anesthetic surgeries.Thus,we designed this study to investigate the intraoperative manifestations of the potentially dangerous complication of VAE in the DBS surgery.Methods:The medical records of a series of 705 consecutive patients who underwent DBS surgery in our hospital have been retrospectively reviewed.The clinical features,intraoperative manifestations and treatment of these patients were analyzed for evidence of VAE.The correlation between the cough intensity and other clinical features were investigated.Results:Evidence of VAE were found in 16 patients.Statistical analyses showed that severe cough is associated with greater age (p =0.045),longer coughing time (p =0.001),more intensive tremor (p =0.032),more complaints (p =0.036),greater influences (p =0.009),more treatment (p =0.003) and longer hospitalization (p =0.003).Conclusions:Intraoperative intense and unremitting cough may be a noticeable indicator of possible VAE.Early recognition and effective management are essential to prevent unfavorable outcomes in such cases.
文摘A 36-year-old woman suffered meningioma in her right cerebellopontine angle.Air embolisms often complicate sitting-position surgeries.Because TEE guides the localization of central venous catheters and promptly locates air embolisms promptly enough for effective treatment,TEE is an effective monitoring method for sitting-position surgeries.
