Evaluation of catheter placement in the treatment of venous air embolism

Venous air embolism is a potential complication of many surgical, therapeutic, and diagnostic procedures. Aspiration of air via a catheter placed in the superior vena cava or right atrium or placed in the pulmonary outflow tract and pulled through the right heart chambers had been advocated for the treatment of venous air embolism. In this study, three catheter positions were analyzed to determine which was best for removal of gas after induction of massive venous air embolism in dogs. In 18 dogs, 9 of which were suspended by their forelegs to simulate the sitting position used in posterior fossa exploration and 9 of which were supine, a Swan-Ganz catheter was placed in the right atrium, right ventricle, or pulmonary artery. A measured amount of air was injected into the left jugular vein and syringe aspiration of the air was attempted through the catheter. In the group with the catheter in the pulmonary artery, aspiration was continuous while the catheter was withdrawn through the right heart chambers. The amount of air aspirated varied widely among the three catheter positions, and no one catheter position proved superior to the other two.