J. Kytta et al., MONITORING LUNG COMPLIANCE AND END-TIDAL OXYGEN-CONTENT FOR THE DETECTION OF VENOUS AIR-EMBOLISM, British Journal of Anaesthesia, 75(4), 1995, pp. 447-451
Venous air embolism (VAE) is a recognized complication of surgery perf
ormed with the patient in the sitting position, but it occurs also dur
ing other operations. We report two cases of VAE, associated with a no
table decrease in dynamic lung compliance, detected by side-stream spi
rometry. Based on these cases, an experiment with 10 pigs was designed
to evaluate the usefulness of side-stream spirometry in the diagnosis
of VAE. Three doses of air (0.5, 1.0 and 2.0 ml kg(-1)) were injected
via the proximal part of a 5-French gauge pulmonary artery catheter.
Only the largest dose was followed by haemodynamic deterioration. Sign
ificant increases in end-tidal oxygen content and decreases in dynamic
lung compliance were detected with all doses of air together with con
ventional signs of VAE, that is increases in pulmonary artery pressure
s and arterial carbon dioxide tensions, and decreases in end-tidal con
centration of carbon dioxide. We conclude that continuous monitoring o
f end-tidal oxygen concentration and side-stream spirometry offers val
uable supplements to other monitoring techniques in the detection of V
AE.