DETECTION OF VENOUS AIR-EMBOLISM BY CONTINUOUS INTRAARTERIAL OXYGEN MONITORING

被引：8

作者：

GREENBLOTT, G ^{[1
]}

BARKER, SJ ^{[1
]}

TREMPER, KK ^{[1
]}

GERSCHULTZ, S ^{[1
]}

GEHRICH, JL ^{[1
]}

机构：

[1] UNIV CALIF IRVINE,IRVINE MED CTR,DEPT ANESTHESIOL,101 CITY DR S,ROUTE 81A,ORANGE,CA 92668

来源：

JOURNAL OF CLINICAL MONITORING | 1990年 / 6卷 / 01期

关键词：

Complications: air embolism; Equipment: optodes; Monitoring: carbon dioxide; oxygen;

D O I：

10.1007/BF02832181

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

In a recent study, we compared a new intraarterial fiberoptic "optode" probe to continuously measure arterial oxygen and carbon dioxide tensions and pH with intermittently drawn blood samples in patients undergoing surgery. In one patient with a diagnosis of Arnold-Chiari type I malformation with outflow obstruction of the fourth ventricle, a major pulmonary air embolism occurred while the patient was undergoing suboccipital craniectomy and cervical laminectomy in the prone position. Three hours after the incision the optode-displayed oxygen tension decreased from a stable value of 225 ±8 mm Hg to 63 mm Hg over a 10-minute period. During the same interval, carbon dioxide tension increased and end-tidal carbon dioxide decreased; shortly thereafter, transcutaneous oxygen tension decreased also. Within 20 minutes after the inspired gas mixture was changed to 100% oxygen, the patient's respiratory variables returned to near baseline. No further complications ensued. This is the first time continuously monitored arterial oxygen tension values during a pulmonary embolism have been reported. With further refinement, intraarterial optode probes will add another valuable method of detecting pulmonary air embolism. © 1990 Little, Brown and Company.

引用

页码：53 / 56

页数：4

共 22 条

[1]

Michenfelder J.D., Terry H.R., Davv E.F., Miller R.H., Air embolism during neurosurgery: a new method of treatment, Anesth Anaig, 45, pp. 390-394, (1966)

[2]

Buchland R.W., Manners J.M., Venous air embolism during neurosurgery, Anaesthesia, 31, pp. 633-643, (1976)

[3]

Michenfelder J.D., Martin J.T., Altenberg B.M., Rehden K., Air embolism during neurosurgery, JAMA, 208, pp. 1353-1358, (1969)

[4]

Glenski J.A., Cucchiara R.F., Michenfelder J.D., Transesophageal echocardiography and transcutaneous O2 and CO2 monitoring for detection of venous air embolism, Anesthesiology, 64, pp. 541-545, (1986)

[5]

Marshall W.K., Bedford R.F., Use of a pulmonary-artery catheter for detection and treatment of venous air embolism, Anesthesiology, 52, pp. 131-134, (1980)

[6]

Maroon J.C., Albin, Air embolism diagnosed by Doppler ultrasound, Anesth Analg, 53, pp. 399-402, (1974)

[7]

Michenfelder J.D., Miller R.H., Gronert G.A., Evaluation of an ultrasonic device (Doppler) for the diagnosis of venous air embolism, Anesthesiology, 36, pp. 164-167, (1972)

[8]

Gildenberg P.L., O'Brian P.A., Britt W.J., Frost E.A., The efficacy of Doppler monitoring for the detection of venous air embolism, J Neurosurgery, 54, pp. 75-78, (1981)

[9]

Bethune R.W.M., Brechner V.L., Detection of venous air embolism by carbon dioxide monitoring, Anesthesiology, 29, (1968)

[10]

Glenski J.A., Cucchiara R.F., Transcutaneous O2 and CO2 monitoring of neurosurgical patients: detection of air embolism, Anesthesiology, 64, pp. 546-550, (1986)

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