Bakan Mefkur, Topuz Ufuk, Esen Asim, Basaranoglu Gokcen, Ozturk Erdogan
MD; Bezmialem Vakif University, School of Medicine, Department of Anesthesiology and Reanimation.
MD; Bezmialem Vakif University, School of Medicine, Department of Anesthesiology and Reanimation.
Braz J Anesthesiol. 2013 Jul-Aug;63(4):362-5. doi: 10.1016/j.bjane.2012.09.001. Epub 2013 Aug 13.
The anesthesiologist must be aware of the causes, diagnosis and treatment of venous air embolism and adopt the practice patterns to prevent its occurrence. Although venous air embolism is a known complication of cesarean section, we describe an unusual inattention that causes iatrogenic near fatal venous air embolism during a cesarean section under spinal anesthesia. One of the reasons for using self-collapsible intravenous (IV) infusion bags instead of conventional glass or plastic bottles is to take precaution against air embolism. We also demonstrated the risk of air embolism for two kinds of plastic collapsible intravenous fluid bags: polyvinyl chloride (PVC) and polypropylene-based. Fluid bags without self-sealing outlets pose a risk for air embolism if the closed system is broken down, while the flexibility of the bag limits the amount of air entry. PVC-based bags, which have more flexibility, have significantly less risk of air entry when IV administration set is disconnected from the outlet. Using a pressure bag for rapid infusion can be dangerous without checking and emptying all air from the IV bag.
麻醉医生必须了解静脉空气栓塞的病因、诊断和治疗方法，并采用相应的操作模式以预防其发生。虽然静脉空气栓塞是剖宫产已知的并发症，但我们描述了一例在脊髓麻醉下剖宫产过程中因异常疏忽导致医源性近乎致命的静脉空气栓塞。使用可自行折叠的静脉输液袋而非传统玻璃瓶或塑料瓶的原因之一是预防空气栓塞。我们还展示了两种塑料可折叠静脉输液袋（聚氯乙烯和聚丙烯材质）导致空气栓塞的风险。如果封闭系统破裂，没有自密封出口的输液袋存在空气栓塞风险，而输液袋的柔韧性会限制空气进入量。聚氯乙烯材质的输液袋柔韧性更强，当静脉输液装置与出口断开时，空气进入的风险显著降低。在未检查并排空输液袋内所有空气的情况下使用压力袋进行快速输液可能很危险。
