NASA Logo

NTRS

NTRS - NASA Technical Reports Server

Back to Results
Effect of body repositioning after venous air embolism. An echocardiographic studyBACKGROUND: Current therapy for massive venous air embolism (VAE) may include the use of the left lateral recumbent (LLR) position, although its effectiveness has been questioned. This study used transesophageal echocardiography to evaluate the effect of body repositioning on intracardiac air and acute cardiac dimension changes. METHODS: Eighteen anesthetized dogs in the supine position received a venous air injection of 2.5 ml/kg at a rate of 5 ml/ s. After 1 min the dogs were repositioned into either the LLR, LLR 10 degrees head down (LLR-10 degrees), right lateral recumbence, or remained in the supine position. RESULTS: Repositioning after VAE resulted in relocation of intracardiac air to nondependent areas of the right heart. Peak right ventricular (RV) diameter increase and mean arterial pressure decrease were greater in the repositioned animals compared with those in the supine position (P < 0.05). Right ventricular diameter and mean arterial pressure showed an inverse correlation (r = 0.81). Peak left atrial diameter decrease was greater in the LLR and LLR-10 degrees positions compared with the supine position (P < 0.05). Repositioning did not influence peak pulmonary artery pressure increase, and no correlation was found between RV diameter and pulmonary artery pressure. All animals showed electrocardiogram and echocardiographic changes reconcilable with myocardial ischemia. CONCLUSIONS: In dogs, body repositioning after VAE provided no benefit in hemodynamic performance or cardiac dimension changes, although relocation of intracardiac air was demonstrated. Right ventricular air did not appear to result in significant RV outflow obstruction, as pulmonary artery pressure increased uniformly in all groups and was not influenced by the relocation of intracardiac air. The combination of increased RV afterload and arterial hypotension, possibly with subsequent RV ischemia rather than RV outflow obstruction by an airlock appeared to be the primary mechanism for cardiac dysfunction after VAE.
Document ID
20040173019
Acquisition Source
Legacy CDMS
Document Type
Reprint (Version printed in journal)
Authors
Geissler, H. J.
(University of Texas-Houston Medical School United States)
Allen, S. J.
Mehlhorn, U.
Davis, K. L.
Morris, W. P.
Butler, B. D.
Date Acquired
August 22, 2013
Publication Date
March 1, 1997
Publication Information
Publication: Anesthesiology
Volume: 86
Issue: 3
ISSN: 0003-3022
Subject Category
Life Sciences (General)
Distribution Limits
Public
Copyright
Other
Keywords
NASA Discipline Environmental Health
NASA Discipline Number 04-10
NASA Program Environmental Health
Non-NASA Center

Available Downloads

There are no available downloads for this record.
No Preview Available