Artru A A
Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195.
Anesth Analg. 1994 Oct;79(4):740-4.
Based on reports of fatal venous air embolism (VAE) occurring during lumbar laminectomy and spinal fusion in prone patients positioned with the abdomen hanging freely, it has been recommended that monitoring for VAE should be used for such cases, and that a multiorificed central venous catheter should be inserted for aspiration of VAE. A previous study from this laboratory reported that, in prone dogs positioned with the abdomen hanging freely, a multiorificed catheter located in the superior portion of the right atrium did not increase the success rate of resuscitation after VAE given via the femoral vein. The present study was designed to examine aspiration of VAE when prone dogs positioned with the abdomen hanging freely were given a fatal VAE via a femoral vein and a multiorificed catheter was located in the inferior portion of the right atrium. Fourteen dogs were anesthetized with isoflurane and nitrous oxide in oxygen and positioned with the abdomen ventral and hanging freely, the head fixed in a stereotaxic frame, the upper extremities resting on a surface approximately 10 cm below the level of the stereotaxic frame and the lower extremities on a surface below the level of the upper extremities (to assure that VAE entering the inferior vena cava would ascend toward the heart). In the control group (n = 7) a catheter was placed in the inferior portion of the right atrium but was not used to aspirate VAE. In a second group (n = 7) a modified Arrow prototype multiorificed catheter was inserted in the inferior portion of the right atrium.(ABSTRACT TRUNCATED AT 250 WORDS)
基于有报告称,在腹部悬空的俯卧位患者进行腰椎椎板切除术和脊柱融合术期间发生致命性静脉空气栓塞(VAE),有人建议对此类病例应进行VAE监测,并应插入多孔中心静脉导管以抽吸VAE。本实验室之前的一项研究报告称,在腹部悬空的俯卧位犬中,位于右心房上部的多孔导管在经股静脉给予VAE后并未提高复苏成功率。本研究旨在检查当腹部悬空的俯卧位犬经股静脉给予致命性VAE且多孔导管位于右心房下部时VAE的抽吸情况。14只犬用异氟烷和氧气中的一氧化二氮麻醉,腹部腹侧悬空,头部固定在立体定位框架中,上肢置于立体定位框架水平以下约10厘米的表面上,下肢置于上肢水平以下的表面上(以确保进入下腔静脉的VAE会朝着心脏上升)。在对照组(n = 7)中,将导管置于右心房下部但未用于抽吸VAE。在第二组(n = 7)中,将改良的Arrow原型多孔导管插入右心房下部。(摘要截短于250字)