監測靜脈空氣栓塞－－未來不是夢？

Is It a Dream-- The Possibility of Development of a New Venous Air Embolism Monitor in the Near Future?

Air embolism is defined as the introduction of air bubbles into the circulation, usually into veins. Venous air embolism (VAE) is a serious and potentially a fatal complication following a variety of surgical procedures and its pathogenesis and pathophysiology should be thoroughly understood by anesthesiologists. In general, the incidence of VAE varies greatly and a rate of 2% to 60% for neurosurgical procedure carried out in the sitting position has been reported. Appropriate intraoperative management of VAE involves the understanding of its etiology, pathophysiologic process and prevention of further embolism. Because prevention is not always possible, appropriate monitors and precautionary measures should be applied in patients at risk to allow early detection and minimize the resultant sequelae. Once VAE is recognized, treatment should immediately begin with halting of the progress to prevent further embolization and measures should be taken to remove or hasten the elimination of the embolizing gas from the circulation. The severity of VAE very much depends on the rate at which the air and total air volume entering the heart chambers. It is thus of paramount importance to carefully and all the time monitor the hemodynamic changes for early detection of massive air embolism.