Sunday, March 30, 2014

A note on CPR in VAE (Venous Air Embolism)




If CPR is required in venous air embolism, patient should be placed in a supine and head-down position.  CPR in venous air embolism serves dual purpose. Beside maintaining cardiac output,  CPR may also help  to break large air bubbles into smaller ones. Literature exists to show that the efficacy of cardiac massage equals to that of putting patient in left lateral position, as well as intracardiac aspiration of air via central venous catheter.



References:

Mirski MA, Lele AV, Fitzsimmons L, Toung TJ. Diagnosis and treatment of vascular air embolism. Anesthesiology. Jan 2007;106(1):164-77.

Sviri S, Woods WP, van Heerden PV. Air embolism--a case series and review. Crit Care Resusc. Dec 2004;6(4):271-6.

Muth CM, Shank ES. Gas embolism. N Engl J Med. Feb 17 2000;342(7):476-82. 

Pronovost PJ, Wu AW, Sexton JB. Acute decompensation after removing a central line: practical approaches to increasing safety in the intensive care unit. Ann Intern Med. Jun 15 2004;140(12):1025-33. 

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