We investigated the effect of the inspired isoflurane concentration (C(I)iso) on body uptake by comparing the isoflurane concentration in the pulmonary artery blood (PAiso) and that in the arterial blood (Aiso) in 16 patients undergoing coronary artery bypass grafting surgery during the 1st, hour of isoflurane anesthesia. The patients received ...

Complications of central venous catheters occur in less than 1% of all insertions. Of these, pulmonary air embolism is a rare though often fatal complication. Possible mechanisms include opening of the line to the atmosphere during use and poor technique during insertion or removal. There has also been speculation that ...

Based on a literature search, an overview is presented of the pathophysiology of venous and arterial gas embolism in the experimental and clinical environment, as well as the relevance and aims of diagnostics and treatment of gas embolism. The review starts with a few historical observations and then addresses venous ...

A commercial airline mechanic was evaluated for right-sided hemianesthesia. Thorough diagnostic testing failed to identify a definitive etiology, and the mechanic was assessed as having symptoms of a left internal capsule lesion, likely from an ischemic event. On day 12 after symptom onset, he consulted a diving medicine specialist for ...

We tested the hypotheses that freezing-induced embolism is related to conduit diameter, and that conifers and angiosperms with conduits of equivalent diameter will exhibit similar losses of hydraulic conductivity in response to freezing. We surveyed the freeze-thaw response of conifers with a broad range of tracheid diameters by subjecting wood ...

Microemboli during extracorporeal circulation (ECC) might be a reason for postoperative neuropsychological dysfunction. This case report shows that reduction of microbubbles in the arterial line, as well as high intensity transient signals (HITS) in the middle cerebral artery (MCA), could be accomplished by use of a dynamic bubble trap (DBT) ...

OBJECTIVE: Pulmonary aspiration is a significant cause of admission to the ITU and is associated with significant morbidity and mortality. Aspiration in the supine position produces posterior collapse/consolidation, similar to that seen in ALI/ARDS patients. Prone positioning has been shown to improve oxygenation in ALI/ARDS, but no studies have been ...

BACKGROUND: Severe emphysema frequently is associated with elevated pulmonary artery systolic pressure. However, it is often difficult to obtain adequate tricuspid regurgitation (TR) signals for measurement of pulmonary artery systolic pressure in patients with severe emphysema. PURPOSE: This study was conducted to evaluate the usefulness of air-blood-saline mixture in measuring ...

A southern giant petrel (Macronectes giganteus) was found dead at Potter Peninsula, King George Island, South Shetland, Antarctica. The adult male was discovered approximately 48 hr after death. Macroscopic and microscopic lesions were compatible with avian cholera and the bacterium Pasteurella multocida subsp. gallicida, serotype A1 was isolated from lung, ...

Prolonged air travel is associated with an increased incidence of thromboembolic events. The occurrence of stroke was studied in patients with pulmonary embolism after air travel in a review of all flights arriving at Charles de Gaulle Airport in Paris during an 8-year period. Thromboembolic stroke and patent foramen ovale ...

Deep hypothermic circulatory arrest may impair cerebral cellular functions, and physiological parameters following circulatory arrest may deviate from the normal. The intention of this study was to monitor jugular venous oxygen saturation during cardiopulmonary bypass before and after deep hypothermic circulatory arrest. Jugular venous oxygen saturation were obtained on 18 ...

BACKGROUND: We studied whether hemodynamic and oxygenation profiles are altered in critically ill patients after exposure to hyperbaric oxygen (HBO). METHODS: Ten intensive-care patients (two females, eight males) undergoing HBO treatment after major abdominal surgery, after burn injury and after CO poisoning were included. All subjects were put on mechanical ...

Pneumothorax is defined as the presence of air within the pleural space and implicates that either the visceral or parietal pleura have been disrupted. In this article the classification of pneumothorax, incidence, pathogenesis, and the radiological evaluation and different quantitative measures of pneumothorax were reviewed. In this communication, we also ...

Pneumoperitoneum usually indicates rupture of a hollow viscus and considered a surgical emergency. But air may also enter the peritoneum from the lung or the genital organs in female without visceral perforation. While scuba diving, the rapid ascent is usually controlled by placing in a decompression chamber and the excess ...

We present a case of paradoxical air embolism in a patient undergoing neurosurgery of the posterior fossa in the sitting position. Paradoxical air embolism was detected in the descending aorta by a transoesophageal Doppler probe, which was inserted primarily for non-invasive haemodynamic monitoring. The patient suffered no serious complications of ...

Rapid consumption of oxygen by leucocytes can result in erroneous diagnosis of severe hypoxaemia in patients with extreme leucocytosis. We report a case of chronic myeloid leukaemia, extreme leucocytosis and arterial hypoxaemia which was out of proportion to the clinical and radiological evidence of lung disease. The pseudohypoxaemia was confirmed ...

BACKGROUND: We sought to identify whether transcutaneous oxygen tension (tcPo2) measurements could be used to noninvasively detect lesions in the arterial network supplying blood flow to the hypogastric circulation. METHODS AND RESULTS: A study was undertaken in vascular patients with suspected (PC, n=43) and not with suspected (NPC, n=34) proximal ...

Normothermic cardiopulmonary bypass has recently been proposed as a superior technique for maintaining body metabolism. However, its use remains controversial since the degree of cerebral protection provided might be inferior to that conferred by conventional hypothermic techniques. We report a case of accidental massive air embolism during coronary artery bypass ...

Patients with acute respiratory distress syndrome have increased lung tissue weight and therefore an increased hydrostatic pressure gradient down the lung. Also, they have a better arterial oxygenation in prone (face down) than in supine (face up) posture. We hypothesized that this effect of the direction of gravity also existed ...

We compared the performance of mainstream capnometry as a measure of arterial carbon dioxide tension (Paco2) with sidestream recordings in adult neurosurgical patients undergoing supine craniotomy. Two hundred and forty patients were randomly assigned so that the end-tidal carbon dioxide tension (PEco2) was measured using either a mainstream or sidestream ...

Entry of air into the venous system leading to intracardiac air and pulmonary air embolism (PAE) has been reported in various clinical settings such as neurosurgical interventions in the sitting position and in autopsies on patients with head and neck injuries. We report the case of a 29-year-old male who ...

Raised internal pressure in a distressed submarine rapidly increases the risk of decompression sickness (DCS) following submarine escape. The hypothesis that breathing a hyperoxic gas during escape may reduce the risk of DCS was tested using goats. Shallow air saturation and simulated submarine escape dives were carried out either singularly ...

BACKGROUND: The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 4% and 19%, and various threshold values defining arterial deoxygenation have been used and recommended previously. However, it is not known ...

We explore three questions concerning arterial hyperoxygenation and focal ischemia. (1) Does greater benefit accrue with higher levels of arterial hyperoxemia? (2) Is the net effect of continuous (intraischemic plus postischemic) oxygen therapy toxic, or beneficial to middle cerebral artery infarction? (3) In view of free radical theories of reperfusion ...

INTRODUCTION: Pulmonary altitude decompression sickness (DCS) is a rare condition. 'Chokes' which are characterized by the triad of substernal pain, cough, and dyspnea, are considered to be associated with severe accumulation of gas bubbles in the pulmonary capillaries and may rapidly develop into a life-threatening medical emergency. This study was ...

Besides the surgeon's experience, there is no objective method to detect whether the retrograde cannula is inserted correctly before injecting the cardioplegia and measuring the coronary sinus pressure after the aorta cross-clamp. Repositioning of the retrograde cannula once extracorporeally is not always an easy maneuver and may include the risk ...

We report the diagnosis of intracoronary air embolism by transesophageal echocardiography in 2 patients undergoing open heart surgery. The sudden appearance of inferior wall akinesis with increased brightness of the area immediately after removal of the aortic cross clamp and spontaneous resolution of the abnormalities support the diagnosis of intracoronary ...

PURPOSE: The authors investigated whether ultrasonic characteristics of embolic signals could be used to differentiate embolic composition. MATERIALS AND METHODS: The authors analyzed high-intensity transient signals (HITS) from 3 patients with patent foramen ovale during the bubble contrast test and during total joint replacement surgery. In 3 anesthetized dogs, latex ...

Extracorporeal membrane oxygenation has been used successfully to support both cardiac and pulmonary function following Stage I Norwood operation. Determination of the return of native cardiac function and pulmonary function can be easily accomplished because of the single ventricle physiology. The pulmonary function can be assessed while on full flow ...

OBJECTIVE: We evaluated the relationship of air trapping to mosaic perfusion in patients with pulmonary embolism. SUBJECTS AND METHODS: Forty-one consecutive patients with suspected pulmonary embolism underwent expiratory CT followed by helical CT angiography. After excluding 12 patients who had airway disease or were smokers, we divided the patients into ...

BACKGROUND: Pulmonary air embolism (PAE) occurs in inappropriate decompressions or clinical complications. Sudden lodging of air bubbles in the pulmonary circulation results in pulmonary hypertension, pulmonary edema, and deficiency in cardiopulmonary functions, which are often fatal without timely intervention. In this study, we investigated the effectiveness of hyperbaric oxygen (HBO2) ...

The effect of wearing occlusive scrub suits on bacterial contamination of air was studied during cataract operations. All personnel regularly wore cotton scrub suits. During the intervention period, all wore occlusive scrub suits, which, compared with cotton scrub suits, were associated with more than a 50% reduction in the load ...

Here, we report on a case of temporary neurological damage following conduit replacement from the right ventricle to pulmonary artery during which vacuum-assisted venous drainage was used. We will discuss the benefits and risks of this technique with potential arterial air embolism despite the use of arterial line filters. We ...

OBJECTIVE: To determine whether currently available preoperative and intraoperative variables related to arterial oxygen tension (PaO(2)) can be used as predictors for low PaO(2) during one-lung ventilation (OLV). DESIGN: A prospective cohort study. SETTING: Primary university hospital. PARTICIPANTS: Adult patients (n = 92) undergoing thoracic surgery requiring OLV. INTERVENTIONS: Preoperative ...

We report on a rare, acute, life-threatening complication during percutaneous thermal therapy for hepatic metastases. Massive cardiac air embolism occurred during a maneuver of deep inspiration after the dislodgment of an introducer sheath into a hepatic vein. The subsequent cardiac arrest was treated successfully by immediate transthoracic evacuation of the ...

An association has been demonstrated between intravascular microemboli and organ injury during cardiopulmonary bypass (CPB). Air may be inadvertently introduced into the venous line during CPB resulting in the formation of gaseous microemboli (GME). We studied the ability of CPB circuits, from five different manufacturers, to remove GME originating from ...

This case report describes the complication of an air embolism in the right coronary artery that developed during coronary angiography in a patient with acute anterior myocardial infarction. Follow-up left ventriculography, 4 months later, showed irreversible inferior wall damage. Incomplete aspiration of the angiographic catheter was the cause of this ...

Systemic venous air embolism is a serious complication in patients with chronic liver disease having liver surgery. Intrapulmonary arteriovenous shunting can permit air emboli to pass into the systemic circulation. We describe a case of paradoxical air embolism detected by transoesophageal echocardiography in a patient with cirrhosis who was having ...

An unusual death caused by carbon monoxide poisoning after the detonation of explosives in an underground mine was investigated by the Office of the Medical Investigator of the State of New Mexico. The 50-year-old miner had 18 years of mining experience but no documented safety training. He collapsed approximately 20 ...

PURPOSE: To determine the clinical consequences of air embolism occurring during insertion of central venous catheters. MATERIALS AND METHODS: A computer search of our interventional radiology database revealed that 11,583 central venous catheters were inserted between January 1, 1995 and August 1, 2000: 7,178 were nontunneled and 4,404 were tunneled. ...

We report the case of a 90-year-old man with syncope, arrhythmia, cardiac ischemia, and neurologic deficit after undergoing spinal epidural injection for control of pain related to post-herpetic neuralgia. The diagnosis of arterial gas embolus was made after air was identified in the left ventricle of the heart on an ...

During venoarterial extracorporeal membrane oxygenation the right carotid artery is ligated in a hypoxic neonate. The aim of the present study was to compare the morphology and metabolism of the left and right basal ganglia in 10 neonates after extracorporeal membrane oxygenation, using proton magnetic resonance imaging and spectroscopy. Data ...

A 22-year-old white male was found dead at his working place in a car lacquering company. He had removed lacquer residues by using a solvent containing dicloromethane (DCM) without using a gas mask. Pathology revealed signs of asphyxiation with obvious petechial bleedings and expressed microthrombosis of the pulmonary arteries. Toxicological ...

This study was aimed to compare changes in hemodynamics between unilateral (UL) or simultaneous bilateral (BL) lung volume reduction surgery (LVRS) for chronic obstructive lung disease. Sixteen patients underwent LVRS by stapler resection with neodymium: yttrium-alminum-garnet (Nd: YAG) laser ablation; five underwent BL-LVRS (four by median sternotomy and one by ...

From 1992 through 1997, there were 41 deaths by homicidal blunt impact head trauma in Hillsborough County, Florida. Twenty-one cases were excluded from the study because of putrefaction or survival beyond the emergency department doors, leaving 20 cases for the study. One of the 15 nonputrefied victims found dead at ...

PURPOSE: Evaluate oxygen jet ventilation in a patient with tracheal stenosis undergoing stent insertion. CLINICAL FEATURES: Manual intermittent low frequency oxygen jet ventilation was used during general anesthesia for fibreoptic bronchoscopy and stent insertion in a patient with tracheal stenosis. Oxygen jets were delivered via a Sander's injector adapted to ...

We report a case of a bright, alert patient with central neurogenic hyperventilation (CNH) associated with cerebral malignant lymphoma. CNH is a syndrome comprising normal or elevated arterial oxygen tension, decreased arterial carbon dioxide tension, and respiratory alkalosis in the absence of cardiac or pulmonary disease that stimulates a compensatory ...

Artery wall hypoxia has been proposed to contribute to many kinds of artery wall pathology, including atherosclerosis and intimal hyperplasia. The purpose of this study was to determine the effect of supplemental oxygen on the transarterial wall oxygen gradients at a prosthetic vascular device (PVG)-to-artery anastomosis. The transarterial wall oxygen ...

PURPOSE: To evaluate the efficacy of video-intuboscopic assisted tracheal intubation in a difficult intubation setting. METHODS: In 50 pediatric patients (mean age 12.8 +/- 3.1 yr, range 6-16 yr) a grade 3 direct laryngoscopic view was simulated. Eight certified registered nurse anesthetists without experience in endoscopic intubation performed tracheal intubation ...

In the newborn period, decreased right atrial pressure results in functional closure of the foramen ovale (FO). The objective of this study was to investigate whether air bubbles infused in the vena cava will pass through the FO into the arterial circulation in a newborn animal. Since air tends to ...