[abstract] MASSIVE VENOUS AIR EMBOLISM: EFFECTS OF BODY POSITION ON RIGHT VENTRICULAR AND LEFT ATRIAL DIMENSIONS

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[abstract] MASSIVE VENOUS AIR EMBOLISM: EFFECTS OF BODY POSITION ON RIGHT VENTRICULAR AND LEFT ATRIAL DIMENSIONS

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Title: [abstract] MASSIVE VENOUS AIR EMBOLISM: EFFECTS OF BODY POSITION ON RIGHT VENTRICULAR AND LEFT ATRIAL DIMENSIONS
Author: Butler, BD; Geissler, HJ; Allen, SJ; Morris, WP; Mehlhorn, U
Abstract: BACKGROUND: We have previously demonstrated (Anes Analg 1994; 79:734-9) that body repositioning after massive venous air embolism (VAE) in dogs does not influence hemodynamic outcome. In this study we evaluated the acute phase of the embolization (first 5 mins), using transesophageal echocardiography (TEE), to determine the effects of repositioning on left atrial (LA) and right ventricular (RV) dimensions following VAE. Further evaluation included the persistence times of venous bubbles in the RA, in view of possible aspiration efforts to maintain adequate cardiac output. METHODS: Eighteen anesthetized, ventilated dogs were embolized with venous air (supine position, SUP) into the RA at a dose of 2.5 ml/kg at a rate of 5 ml/sec. After 1 min ventilation was switched to 100percent oxygen and the dogs repositioned into either: left lateral (LL, n = 4), left lateral 10 head down (LL-10, n = 4) or right lateral (RL, n = 6) position. Four dogs remained in SUP. TEE images were recorded for determination of LA and RV dimensions and peristence of RA bubbles. Hemodynamic data collected included arterial, pul. arterial, central venous and left ventricular end-diastolic blood pressure, cardiac output and ECG. Data were collected for each min following the VAE for 5 min then in 15 min intervals for 180 min. RESULTS: Peak increases in RV diameters were significantly greater in the three lateral positions (35percent, 25percent, 28percent, respectively) compared to SUP (11percent, p less than 0.05) while LA diameters were decreased (p less than 0.05) comparing SUP to LL and LL-10. Arterial blood pressures were decreased by as much as 70percent of baseline (p less than 0.05) for the lateral positions and 40percent (ns) for SUP dogs. The change in blood pressure correlated with LA diameter changes (r = 0.75) and RV diameters remained increased even after 180 min recovery and return to baseline hemodynamic values. Air persisted in the RA for 11 min in the left lateral positions vs. 2.3 min (p less than 0.05) in the SUP position. CONCLUSION: Massive VAE results in acute changes in hemodynamics and cardiac dimensions. Therapeutic efforts involving the repositioning of the subject is shown to effect no significant benefit in terms of more rapid restoration of baseline cardiac dimensions or in clearance of RA air. Supported in part by NASA NAGW 4479.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/538
Date: 1996

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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