The effectiveness of venoarterial perfusion in treatment of arterial air embolism during cardiopulmonary bypass.
In an experimental study using 6 pigs, the clinical situation of accidental air embolism was mimicked by introducing a known amount of pure nitrogen into the aortic perfusion line during standard hypothermic cardiopulmonary bypass. The treatment after embolization consisted of 15 minutes of perfusion flow reversal. A special device was built to enable quantitative assessment of the amount of gas that escaped through the aortic cannula during venoarterial perfusion. This showed that only 47% of the injected gas bolus could be removed from the circulation. However, microscopic and histological examinations of the brain of each pig one week post-operatively did not reveal trapped gas or ischemic tissue damage. It is concluded that hyperbaric treatment after a clinical accident involving air embolism should be used if the embolus has reached the periphery before flow reversal can be effected. Since over 50% of the amount of gas introduced into the vasculature may remain behind even after prolonged venoarterial perfusion, ischemic damage of organs is still possible.
D000818:Animals; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D004618:Embolism, Air / Q000209:etiology / Q000628:therapy*; D006931:Hyperbaric Oxygenation / Q000009:adverse effects; D007431:Intraoperative Complications / Q000628:therapy; D010477:Perfusion