scholarly journals Disseminated intravascular coagulation following air embolism during orthotropic liver transplantation: is this just a coincidence?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karolina Arstikyte ◽  
Gintare Vitkute ◽  
Vilma Traskaite-Juskeviciene ◽  
Andrius Macas
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Disseminated Intravascular Coagulation ◽  
Vena Cava ◽  
Rare Event ◽  
Air Embolism ◽  
Venous Air Embolism ◽  
Intravascular Coagulation ◽  
Arterial Blood ◽  
End Tidal

Abstract Background During orthotopic liver transplantation, venous air embolism may occur due to iatrogenic injury of the inferior vena cava. However, venous air embolism followed by coagulopathy is a rare event. In this case report, we discuss a possible connection between venous air embolism and disseminated intravascular coagulation. Case presentation A 37-year-old male patient with chronic hepatitis B- and C-induced liver cirrhosis was admitted for orthotopic liver transplantation. During the dissection phase of the surgery, arterial blood pressure, heart rate, saturation and end-tidal carbon dioxide levels suddenly decreased, indicating the occurrence of venous air embolism. After stabilizing the patient’s condition, various coagulation issues started developing. Venous air embolism-induced coagulopathy was handled by administering transfusions of various blood products. However, the patient’s condition continued to deteriorate leading to a complete asystole. Conclusions This is a rare case of venous air embolism-induced disseminated intravascular coagulation. The real connection remains unclear as disseminated intravascular coagulation for end-stage liver disease patients can be induced by various causes during different stages of liver transplantation. Certainly, both venous air embolism and coagulopathy were significant and led to an unfavorable outcome. Further studies are needed to better understand the possible mechanisms and correlation between these two life-threatening complications.

scholarly journals Venous air embolism during orthotopic liver transplantation in a child

1997 ◽  
Vol 44 (11) ◽  
pp. 1187-1190 ◽  
Author(s):  
Vincent Souron ◽  
Dominique Fletcher ◽  
Etienne Goujard ◽  
Claude Ecoffey
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Air Embolism ◽  
Venous Air Embolism

Massive Venous Air Embolism during Orthotopic Liver Transplantation

1990 ◽  
Vol 72 (1) ◽  
pp. 198-199 ◽  
Author(s):  
MARIE CSETE PRAGER ◽  
GEORGE A. GREGORY ◽  
NANCY L. ASCHER ◽  
JOHN P. ROBERTS
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Air Embolism ◽  
Venous Air Embolism

Venous Air Embolism During Orthotopic Liver Transplantation in a Child

1998 ◽  
Vol 42 (5) ◽  
pp. 287
Author(s):  
VINCENT SOURON ◽  
DOMINIQUE FLETCHER ◽  
ETIENNE GOUJARD ◽  
CLAUDE ECOFFEY
Keyword(s):  
Liver Transplantation ◽  
Orthotopic Liver Transplantation ◽  
Air Embolism ◽  
Venous Air Embolism

scholarly journals Not fatal venous air embolism after holmium laser enucleation of the prostate: Case report and review of literature

2020 ◽  
Vol 92 (1) ◽  
pp. 55-57
Author(s):  
Daniele Romagnoli ◽  
Mobin Ghaemian ◽  
Daniele D'Agostino ◽  
Paolo Corsi ◽  
Marco Giampaoli ◽  
...  
Keyword(s):  
Rare Complication ◽  
Air Embolism ◽  
Holmium Laser ◽  
Oxygen Saturation Level ◽  
Venous Air Embolism ◽  
Arterial Blood ◽  
Urinary Tract Symptoms ◽  
Laser Enucleation ◽  
End Tidal ◽  
Holmium Laser Enucleation

Objective: Holmium laser has demonstrated high efficacy in urethral disobstruction. Venous air embolism (VAE) is a rare complication of prostate surgery. Only two cases of venous air embolism (VAE) in patients submitted to HoLEP, have been described. In this paper we show a third case of not fatal VAE after HoLEP. Materials and methods: A case of VAE occurred in holmium laser enucleation (HoLEP) due to obstructive lower urinary tract symptoms (LUTS) in a 70 years old patient. After the procedure, patient’s end tidal carbon dioxide (ETCO2) levels dramatically decreased at 17 mmHg, with pressure airway (PAW)16 mmHg; oxygen saturation level was at 75%, without any loss in the ventilation circuit and with arterial blood pressure of 94/54 mmHg. Due to the negativity for other suspicions, the suspect of VAE was postulated. Result: The immediate switching from laryngeal mask to Oro Tracheal Intubation increased the oxygen level. A cardiac transthoracic ultrasound was negative for air bubbles inside cardiac cavities, without any alteration in the cardiac kinetics. Arterial blood sample turned negative for any alteration compatible with VAE and catheter continuous vesical irrigation was started to obtain clear washing fluid without blood cloths. The extubated patient showed no neurological defects. Conclusions: An invasive monitoring system is the key to rapidly and correctly identify any embolic episode during this kind of surgery.

Oncological emergencies

2007 ◽  
pp. 655-674
Keyword(s):  
Spinal Cord ◽  
Allergic Reaction ◽  
Disseminated Intravascular Coagulation ◽  
Superior Vena ◽  
Vena Cava ◽  
Cord Compression ◽  
Tumour Lysis ◽  
System Involvement ◽  
Intravascular Coagulation ◽  
Systemic Allergic Reaction

Anaphylaxis 656 Disseminated intravascular coagulation 658 Malignancy induced hypercalcaemia 660 Spinal cord compression 664 Superior vena cava obstruction 668 Syndrome of inappropriate antidiuretic hormone 670 Tumour lysis syndrome 672 Anaphylaxis is a severe systemic allergic reaction with multi-system involvement. Onset is normally immediate, but there can be a delay of hours....

scholarly journals Hypoxaemia following Sustained Low-Volume Venous Air Embolism in Sheep

1988 ◽  
Vol 16 (2) ◽  
pp. 164-170 ◽  
Author(s):  
J. Pfitzner ◽  
S. P. Petito ◽  
A. G. McLean
Keyword(s):  
Arterial Oxygen Saturation ◽  
Air Embolism ◽  
Arterial Oxygen ◽  
Venous Air Embolism ◽  
Minute Period ◽  
Volume Ventilation ◽  
Gas Measurements ◽  
Respiratory Disturbance ◽  
Upright Head ◽  
End Tidal

In six upright (head above thorax) anaesthetised sheep, serial blood gas measurements were made over a 100-minute period during which repeated small-volume air emboli were injected intravenously to lower and maintain the end-tidal CO 2 concentration approximately 0.5% below its initial baseline level. With constant volume ventilation and an inspired N 2 O:O 2 ratio of 2:1, the arterial PCO 2 progressively increased and the arterial PO 2 progressively decreased with significant arterial hypoxaemia ensuing in three out of the six animals. It is suggested that during neurosurgery performed in the sitting position and with an inspired oxygen concentration of 33%, the degree of cardio-respiratory disturbance caused by venous air embolism should be assessed by continuous monitoring not only of end-tidal CO 2 concentration but also of arterial oxygen saturation using pulse oximetry.

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