Successful resuscitation of cardiac arrest caused by CO2 embolism with intra-aortic injection of epinephrine during off-pump coronary bypass surgery

Title
Successful resuscitation of cardiac arrest caused by CO2 embolism with intra-aortic injection of epinephrine during off-pump coronary bypass surgery
Authors
이춘수; 임현경
Keywords
Ascending aorta, Cardiac arrest, Epinephrine, Gas embolism, Off-pump coronary artery bypass
Issue Date
2013
Publisher
KOREAN JOURNAL OF ANESTHESIOLOGY
Series/Report no.
KOREAN JOURNAL OF ANESTHESIOLOGY ; 제65권 제6호 pp 562~564
Abstract
Although compressed gas (CO2) blowers have been used safely to aid accurate grafting during off-pump coronary bypass surgery, hemodynamic collapse due to gas embolism into the right coronary artery may occur. Supportive measures to facilitate gas clearance by increasing the coronary perfusion pressure have been reported to be successful in restoring hemodynamic stability. However, right ventricular dysfunction and atrioventricular nodal ischemia may hinder effective systemic delivery of the vasoactive medications, even when performing resuscitative measures such as direct cardiac massage. We herein report a case of cardiac arrest that was caused by a right coronary gas embolism and that could not be restored by cardiac resuscitation. When supportive measures fail, direct aortic injection of epinephrine to increase the coronary perfusion pressure can be attempted before initiating cardiopulmonary bypass, and this approach may be lifesaving in situations that limit systemic drug delivery from the venous side despite the performance of direct cardiac massage.
URI
http://dx.doi.org/10.4097/kjae.2013.65.6.562
http://dspace.inha.ac.kr/handle/10505/33837
ISSN
2005-6419
Appears in Collections:
Medical School/College of Medicine (의학전문대학원/의과대학) > Medical Science (의학) > Local Access Journal Papers, Reports(의학 논문, 보고서)

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