A. Boussuges et al., Venous gas embolism: Detection with pulsed Doppler guided by two-dimensional echocardiography, ACT ANAE SC, 43(3), 1999, pp. 328-332
Citations number
20
Categorie Soggetti
Aneshtesia & Intensive Care","Medical Research Diagnosis & Treatment
Background: Venous gas embolism is a rare but severe event in critically il
l patients and the diagnosis should be obtained as soon as possible. Ultras
onography is a sensitive, non-invasive, and bedside means of detection.
Method: We prospectively estimated the performance of two-dimensional (2D)
echocardiography and pulsed Doppler guided by 2D echocardiography in the de
tection of venous embolism. We used, as a model of venous gas embolism, the
decompression following a recreational dive. This activity is responsible
for circulating bubbles related to nitrogen desaturation.
Results: Venous gas emboli were detected following 44 of 68 dives in 20 of
24 divers. Gas emboli in 36 cases (16 divers) was shown by 2D echocardiogra
phy. Parasternal short-axis and right-cavity longitudinal views were the be
st views for positive detection. Pulsed Doppler confirmed the existence of
venous gas emboli in all of the 36 cases with positive detection by 2D echo
-cardiography. In 8 other cases, pulsed Doppler detected circulating bubble
s, which were not observed by using 2D echocardiography. Discrepancies were
observed in 4 divers with an echographic image of medium or poor quality.
Conclusion: Combined utilization of 2D echocardiography and pulsed Doppler
provides a better method for the detection of venous gas embolism than 2D e
chocardiography alone. This protocol could be used for critically ill patie
nts suspected of ve nous air embolism.