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Canadian Journal of Anesthesia, Vol 44, 1187-1190, Copyright © 1997 by Canadian Anesthesiologists' Society

ARTICLES

Venous air embolism during orthotopic liver transplantation in a child

V Souron, D Fletcher, E Goujard and C Ecoffey
Departement d'Anesthesie-Reanimation Chirurgicale, Hoptial de Bicetre, Kremlin, Bicetre, France.

PURPOSE: A first case of massive venous air embolism is reported as a complication of orthotopic liver transplantation in a 17-month-old child during the dissection phase. CLINICAL FEATURES: During the hepatic dissection phase, perforation of suprahepatic veins was responsible for an air embolism with a decrease of P(ET)CO2 (27 to 6 mmHg), hypoxaemia (SpO2 decreased from 100 to 88%), and haemodynamic instability (systolic blood pressure decreased from 85 to 50 mmHg, central venous pressure increased from 6 to 10 mmHg). Central venous aspiration of air was unsuccessful but immediate resolution occurred and neurological outcome was normal. CONCLUSION: Venous air embolism during the dissection phase of liver transplantation in children is a risk that should be considered




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Copyright © 1997 by the Canadian Anesthesiologists' Society.