[Intraoperative vascular air embolism : Evidence for risks, diagnostics and treatment].

Area of Science:

• Medical Science
• Surgical Safety
• Anesthesiology

Background:

• Vascular air embolism (VAE) is the entry of gases into the vascular system, posing a risk of severe complications like cardiocirculatory arrest.
• VAE can occur during various surgical procedures and routine medical tasks, often unexpectedly, due to an open connection between the environment and venous vessels under subatmospheric pressure.

Purpose of the Study:

• To highlight the risks and consequences of vascular air embolism (VAE).
• To outline preventive and intraoperative management strategies for VAE.

Main Methods:

• Review of VAE occurrence during different surgical and non-surgical procedures.
• Discussion of diagnostic utility of transesophageal echocardiography (TEE) for VAE detection.
• Compilation of intraoperative management techniques for VAE.

Main Results:

• VAE can arise during ENT, hip, pelvic, breast surgeries, central venous catheter manipulation, and endoscopic procedures.
• Transesophageal echocardiography (TEE) is vital for ruling out patent foramen ovale preoperatively and detecting VAE intraoperatively.
• Effective management involves communication, volume maintenance, patient positioning, surgical technique, TEE monitoring, and specific interventions like Trendelenburg positioning and air aspiration.

Conclusions:

• Minimizing VAE incidence and severity relies on avoiding air embolism and implementing comprehensive intraoperative measures.
• Vigilance and preparedness are essential for managing VAE, especially in procedures where it's not the primary focus.