Storm Benjamin S, Andreasen Stine, Hovland Anders, Nielsen Erik W
From the Departments of *Anesthesia and Intensive Care, †Gynecology and Obstetrics, and ‡Cardiology, Nordland Hospital, Bodø, Norway; and §Institute of Clinical Medicine, University of Tromsø, Nord University, Bodø, and University of Oslo, Norway.
A A Case Rep. 2017 Sep 1;9(5):140-143. doi: 10.1213/XAA.0000000000000549.
During a period of 1 month, 3 episodes of probable or actual venous air embolism occurred during hysteroscopic surgery. All patients developed the same symptoms of ventilatory and hemodynamic decompensation, beginning with a reduction in end-tidal carbon dioxide, arterial desaturation, and cyanosis on the upper trunk, and rapidly progressed to hypotension and 2 cardiac arrests. While entrainment of some air is common during hysteroscopy, life-threatening embolism is a rare but serious complication for which an anesthetist needs to be vigilant and prepared. If even a small drop in end-tidal carbon dioxide occurs, venous air embolism should be suspected and the operation should be discontinued.
在1个月的时间内，宫腔镜手术期间发生了3起可能或实际的静脉空气栓塞事件。所有患者均出现相同的通气和血流动力学失代偿症状，始于呼气末二氧化碳降低、动脉血氧饱和度下降以及上半身发绀，并迅速发展为低血压和2次心脏骤停。虽然宫腔镜检查期间夹带一些空气很常见，但危及生命的栓塞是一种罕见但严重的并发症，麻醉师需要对此保持警惕并做好准备。如果呼气末二氧化碳哪怕只是轻微下降，都应怀疑发生静脉空气栓塞，并应停止手术。
