Air Embolism in Cardiac Surgery: Incidence and Prophylaxis1

This is a brief review of some of the physiological consequences of air embolism, followed by a discussion of the results of a comparative study between two consecutive series of patients, the first prior to the introduction of the strict routines now practised, and the second after this had been introduced. The techniques in current use for prophylaxis against air embolism are presented.

The incidence and outcome of systemic air embolism occurring in 520 patients have been estimated from records of cerebral disturbance. Two series of patients are compared, the first prior to the introduction of strictly planned "debubbling", and the second after this time. The comparisons shows a marked fall in the incidence and severity of this complication in the recent series. Techniques used for removal of air in specific operations have been presented. Pulmonary air embolism has been discussed. While no direct relationship between bilateral atelectasis and pulmonary air embolism has been shown, there is a strong probability that it has been in the past responsible for this, at least in some part and in conjunction with other factors.