Embolia Gasosa Venosa Inadvertida Durante Cesariana: Bolsas Retráteis para Líquidos Intravenosos sem Saídas Autovedantes Oferecem Riscos. Relato de Caso

Embolia Gasosa Venosa Inadvertida Durante Cesariana: Bolsas Retráteis para Líquidos Intravenosos sem Saídas Autovedantes Oferecem Riscos. Relato de Caso

Brazilian Journal of Anesthesiology (Science Direct), July 2013

23931252

Mefkur Bakan, Ufuk Topuz, Asim Esen, Gokcen Basaranoglu, Erdogan Ozturk

The anesthesiologist must be aware of the causes, diagnosis and treatment of venous air embolism and adopt the practice patterns to prevent its occurrence. Although venous air embolism is a known complication of cesarean section, we describe an unusual inattention that causes iatrogenic near fatal venous air embolism during a cesarean section under spinal anesthesia. One of the reasons for using self-collapsible intravenous (IV) infusion bags instead of conventional glass or plastic bottles is to take precaution against air embolism. We also demonstrated the risk of air embolism for two kinds of plastic collapsible intravenous fluid bags: polyvinyl chloride (PVC) and polypropylene-based. Fluid bags without self-sealing outlets pose a risk for air embolism if the closed system is broken down, while the flexibility of the bag limits the amount of air entry. PVC-based bags, which have more flexibility, have significantly less risk of air entry when IV administration set is disconnected from the outlet. Using a pressure bag for rapid infusion can be dangerous without checking and emptying all air from the IV bag.