Protection from venous air embolism with fluorocarbon emulsion FC-43

Intraoperative venous air embolism (VAE) occurs frequently in some surgical settings and may cause devastating hemodynamic consequences. Perfluorocarbon emulsions have been investigated as artificial oxygen carrying medias. They also have the properties of enhanced nitrogen solubility and a small particle size. FC-43 (Oxypherol, Alpha Therapeutic Corp., Los Angeles, California) was compared to three other volume expanders in 91 New Zealand White laboratory rabbits exposed to continuous VAE. The animals were anesthetized and ventilated by one of four modalities. They then received one of the volume expanders at 20 cc/kg over 30 min. After a 10-min stabilization period, a constant femoral venous air infusion (0.25 cc/kg/min) was begun and continued until death. Time until death, total volume of air infused, femoral arterial pressure, central venous pressure, and ECG (Lead II) were recorded. Death was defined as the cessation of pulsatile blood pressure. Arterial and central venous gases were analyzed pre and post volume expansion and at intervals of every 5 min after the beginning of the femoral air infusion. Results showed a significant prolongation of life for the animals receiving FC-43 at 10 and 20 cc/kg as a volume expander and mechanically ventilated with 100% oxygen as compared to all other groups (P less than 0.05). PaO2 and PvO2 were consistently higher in the group receiving FC-43 as a volume expander. Central venous pressure was lower during air embolism in the FC-43 group. The mechanism for the enhanced survivability of rabbits pretreated with FC-43 volume expansion exposed to VAE is under further investigation.