Placement of a multiorificed catheter in the inferior portion of the right atrium; percentage of gas retrieved and success rate of resuscitation after venous air embolism in prone dogs positioned with the abdomen hanging freely.

Abstract

Based on reports of fatal venous air embolism (VAE) occurring during lumbar laminectomy and spinal fusion in prone patients positioned with the abdomen hanging freely, it has been recommended that monitoring for VAE should be used for such cases, and that a multiorificed central venous catheter should be inserted for aspiration of VAE. A previous study from this laboratory reported that, in prone dogs positioned with the abdomen hanging freely, a multiorificed catheter located in the superior portion of the right atrium did not increase the success rate of resuscitation after VAE given via the femoral vein. The present study was designed to examine aspiration of VAE when prone dogs positioned with the abdomen hanging freely were given a fatal VAE via a femoral vein and a multiorificed catheter was located in the inferior portion of the right atrium. Fourteen dogs were anesthetized with isoflurane and nitrous oxide in oxygen and positioned with the abdomen ventral and hanging freely, the head fixed in a stereotaxic frame, the upper extremities resting on a surface approximately 10 cm below the level of the stereotaxic frame and the lower extremities on a surface below the level of the upper extremities (to assure that VAE entering the inferior vena cava would ascend toward the heart). In the control group (n = 7) a catheter was placed in the inferior portion of the right atrium but was not used to aspirate VAE. In a second group (n = 7) a modified Arrow prototype multiorificed catheter was inserted in the inferior portion of the right atrium.(ABSTRACT TRUNCATED AT 250 WORDS)