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The Annals of Thoracic Surgery, Vol 36, 433-436, Copyright © 1983 by The Society of Thoracic Surgeons

ARTICLES

The effectiveness of venoarterial perfusion in treatment of arterial air embolism during cardiopulmonary bypass

FF Hendriks, AJ Bogers, A Brutel de la Riviere, HA Huysmans and GA Brom

In an experimental study using 6 pigs, the clinical situation of accidental air embolism was mimicked by introducing a known amount of pure nitrogen into the aortic perfusion line during standard hypothermic cardiopulmonary bypass. The treatment after embolization consisted of 15 minutes of perfusion flow reversal. A special device was built to enable quantitative assessment of the amount of gas that escaped through the aortic cannula during venoarterial perfusion. This showed that only 47% of the injected gas bolus could be removed from the circulation. However, microscopic and histological examinations of the brain of each pig one week post-operatively did not reveal trapped gas or ischemic tissue damage. It is concluded that hyperbaric treatment after a clinical accident involving air embolism should be used if the embolus has reached the periphery before flow reversal can be effected. Since over 50% of the amount of gas introduced into the vasculature may remain behind even after prolonged venoarterial perfusion, ischemic damage of organs is still possible.

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