title: Successful management of air embolism-induced ventricular fibrillation in orthotopic liver transplantation.
abstract: Ventricular fibrillation (VF) although less common during noncardiac surgery often brings about severe complication as an aftermath. We report a case of VF which was highly suspected to be induced by air embolism at the moment when the surgeon was dissecting the collateral vessels of portal vein in liver transplantation surgery. The outcome of this patient was excellent due to aggressive resuscitative measures including open-chest cardiac massage. Transesophageal echocardiogram (TEE) was not applied in this patient in fear of increased risk of esophageal varicose bleeding in a liver cirrhotic patient. However, some reports described the use of TEE in cirrhotic patients without obvious complications. In this case, venous air embolism (VAE) happened during the dissection of collateral vessels of the portal vein, which to our knowledge was ever been reported in liver transplantation surgery. The related literature has been reviewed and the success of the resuscitation is also herein discussed.
authors.affiliation: Department of Anesthesiology, National Cheng Kung University Medical College, Tainan, Taiwan, ROC.
authors.forename: Pei-An
authors.initials: PA
authors.lastname: Yeh
authors.forename: Han-Ping
authors.initials: HP
authors.lastname: Chen
authors.forename: Yu-Chuan
authors.initials: YC
authors.lastname: Tsai
authors.forename: Yih-Jyh
authors.initials: YJ
authors.lastname: Lin
authors.forename: Yen-Chin
authors.initials: YC
authors.lastname: Liu
mesh_terms: D017548:Echocardiography, Transesophageal; D004618:Embolism, Air / Q000150:complications*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D014693:Ventricular Fibrillation / Q000628:therapy*