Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies
Complications and critical events during cardiopulmonary bypass (CPB) are very challenging, difficult to manage, and in some instances have the potential to lead to fatal outcomes. Massive cerebral air embolism is undoubtedly a feared complication during CPB. If not diagnosed and managed early, its...
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ir-10336-232962022-05-02T12:37:21Z Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies Quintero O.L. Giraldo J.C. Sandoval N.F. Fentanyl Isoflurane Milrinone Noradrenalin Adult Air embolism Aortic clamping Article Bispectral index Brain perfusion Cardiopulmonary bypass Case report Clinical article Computer assisted tomography Congenital heart disease Early diagnosis Female Heart right ventricle Heart septum defect Heart tamponade Hemodynamic monitoring Human Hyperthermia Intensive care unit Mediastinum Near infrared spectroscopy Neuroprotection Oxygen saturation Physical examination Pulmonary artery Pulmonary valve Sternotomy Transesophageal echocardiography Tricuspid valve regurgitation Tricuspid valve repair Vacuum assisted closure Young adult Air embolism Brain embolism Cardiopulmonary bypass Diagnostic imaging Intraoperative monitoring Neuroprotection Peroperative complication Procedures Cardiopulmonary bypass Female Humans Intracranial embolism Intraoperative complications Neuroprotection Young adult Air embolism Cardiac surgical procedures Cardiopulmonary bypass Cerebrovascular circulation Intracranial embolism Neuroprotection near-infrared air intraoperative Embolism Monitoring Spectroscopy Complications and critical events during cardiopulmonary bypass (CPB) are very challenging, difficult to manage, and in some instances have the potential to lead to fatal outcomes. Massive cerebral air embolism is undoubtedly a feared complication during CPB. If not diagnosed and managed early, its effects are devastating and even fatal. It is a catastrophic complication and its early diagnosis and intraoperative management are still controversial. This is why the decision-making process during a massive cerebral air embolism represents a challenge for the entire surgical, anesthetic, and perfusion team. All caregivers involved in this event must synchronize their responses quickly, harmoniously, and in such a way that all interventions lead to minimizing the impact of this complication. Its occurrence leaves important lessons to the surgical team that faces it. The best management strategy for a complication of this type is prevention. Nevertheless, a surgical team may ultimately be confronted with such an occurrence at some point despite all the prevention strategies, as was the case with our patient. That is why, in each institution, no effort should be spared to establish cost-effective strategies for early detection and a clear and concise management protocol to guide actions once this complication is detected. It is the duty of each surgical team to determine and clearly organize which strategies will be followed. The purpose of this case study was to demonstrate that a massive air embolism can be rapidly detected using near-infrared spectroscopy monitoring and can be successfully corrected with a multimodal neuroprotection strategy. © The Author(s) 2018. 2019 2020-05-26T00:00:59Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 10892532 https://repository.urosario.edu.co/handle/10336/23296 https://doi.org/10.1177/1089253218819782 eng info:eu-repo/semantics/openAccess application/pdf SAGE Publications Inc. instname:Universidad del Rosario |
institution |
EdocUR - Universidad del Rosario |
collection |
DSpace |
language |
Inglés (English) |
topic |
Fentanyl Isoflurane Milrinone Noradrenalin Adult Air embolism Aortic clamping Article Bispectral index Brain perfusion Cardiopulmonary bypass Case report Clinical article Computer assisted tomography Congenital heart disease Early diagnosis Female Heart right ventricle Heart septum defect Heart tamponade Hemodynamic monitoring Human Hyperthermia Intensive care unit Mediastinum Near infrared spectroscopy Neuroprotection Oxygen saturation Physical examination Pulmonary artery Pulmonary valve Sternotomy Transesophageal echocardiography Tricuspid valve regurgitation Tricuspid valve repair Vacuum assisted closure Young adult Air embolism Brain embolism Cardiopulmonary bypass Diagnostic imaging Intraoperative monitoring Neuroprotection Peroperative complication Procedures Cardiopulmonary bypass Female Humans Intracranial embolism Intraoperative complications Neuroprotection Young adult Air embolism Cardiac surgical procedures Cardiopulmonary bypass Cerebrovascular circulation Intracranial embolism Neuroprotection near-infrared air intraoperative Embolism Monitoring Spectroscopy |
spellingShingle |
Fentanyl Isoflurane Milrinone Noradrenalin Adult Air embolism Aortic clamping Article Bispectral index Brain perfusion Cardiopulmonary bypass Case report Clinical article Computer assisted tomography Congenital heart disease Early diagnosis Female Heart right ventricle Heart septum defect Heart tamponade Hemodynamic monitoring Human Hyperthermia Intensive care unit Mediastinum Near infrared spectroscopy Neuroprotection Oxygen saturation Physical examination Pulmonary artery Pulmonary valve Sternotomy Transesophageal echocardiography Tricuspid valve regurgitation Tricuspid valve repair Vacuum assisted closure Young adult Air embolism Brain embolism Cardiopulmonary bypass Diagnostic imaging Intraoperative monitoring Neuroprotection Peroperative complication Procedures Cardiopulmonary bypass Female Humans Intracranial embolism Intraoperative complications Neuroprotection Young adult Air embolism Cardiac surgical procedures Cardiopulmonary bypass Cerebrovascular circulation Intracranial embolism Neuroprotection near-infrared air intraoperative Embolism Monitoring Spectroscopy Quintero O.L. Giraldo J.C. Sandoval N.F. Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies |
description |
Complications and critical events during cardiopulmonary bypass (CPB) are very challenging, difficult to manage, and in some instances have the potential to lead to fatal outcomes. Massive cerebral air embolism is undoubtedly a feared complication during CPB. If not diagnosed and managed early, its effects are devastating and even fatal. It is a catastrophic complication and its early diagnosis and intraoperative management are still controversial. This is why the decision-making process during a massive cerebral air embolism represents a challenge for the entire surgical, anesthetic, and perfusion team. All caregivers involved in this event must synchronize their responses quickly, harmoniously, and in such a way that all interventions lead to minimizing the impact of this complication. Its occurrence leaves important lessons to the surgical team that faces it. The best management strategy for a complication of this type is prevention. Nevertheless, a surgical team may ultimately be confronted with such an occurrence at some point despite all the prevention strategies, as was the case with our patient. That is why, in each institution, no effort should be spared to establish cost-effective strategies for early detection and a clear and concise management protocol to guide actions once this complication is detected. It is the duty of each surgical team to determine and clearly organize which strategies will be followed. The purpose of this case study was to demonstrate that a massive air embolism can be rapidly detected using near-infrared spectroscopy monitoring and can be successfully corrected with a multimodal neuroprotection strategy. © The Author(s) 2018. |
format |
Artículo (Article) |
author |
Quintero O.L. Giraldo J.C. Sandoval N.F. |
author_facet |
Quintero O.L. Giraldo J.C. Sandoval N.F. |
author_sort |
Quintero O.L. |
title |
Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies |
title_short |
Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies |
title_full |
Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies |
title_fullStr |
Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies |
title_full_unstemmed |
Successful Management of Massive Air Embolism During Cardiopulmonary Bypass Using Multimodal Neuroprotection Strategies |
title_sort |
successful management of massive air embolism during cardiopulmonary bypass using multimodal neuroprotection strategies |
publisher |
SAGE Publications Inc. |
publishDate |
2019 |
url |
https://repository.urosario.edu.co/handle/10336/23296 https://doi.org/10.1177/1089253218819782 |
_version_ |
1740172937572384768 |
score |
12,131701 |