Suspected systemic gas embolism associated with lung tissue perforation caused by a previously inserted chest drain in a dog

IF 1.1 3区 农林科学 Q3 VETERINARY SCIENCES Journal of veterinary emergency and critical care Pub Date : 2023-08-12 DOI:10.1111/vec.13318
Iago Asorey DVM, DECVAA, Federico Corletto DVM, PhD, DECVAA
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Abstract

Objective

To report a case of systemic gas embolism associated with removal of a chest drain perforating a lung lobe in a dog undergoing sternotomy under general anesthesia and intermittent positive pressure ventilation.

Case Summary

An 8-year-old Cocker Spaniel underwent an exploratory thoracotomy via median sternotomy for surgical management of pyothorax that was treated conservatively for 7 days prior to referral following bilateral chest drain placement. The surgical procedure consisted of a subphrenic mediastinectomy and pericardiectomy. During surgery, it became apparent that the right drain was perforating the right middle lung lobe. Sudden desaturation and rapid hemodynamic deterioration occurred after the drain was removed. A systemic gas embolism was suspected on the basis of clinical signs and results of an arterial blood gas analysis, and immediate supportive treatment was started with an adequate response. Once the surgical procedure was completed, a clear “mill wheel” sound was audible on cardiac auscultation and point-of-care cardiac ultrasound confirmed the presence of gas bubbles in the cardiac chambers. The dog recovered from anesthesia and was managed in the intensive care unit where arterial blood gas analyses were nearly normal and the dog made a full recovery.

New or Unique Information Provided

In people, there are reports of fatal air embolism related to the use of chest drains. To our knowledge, this is the first case report in dogs of a systemic gas embolism during open-chest surgery caused by a chest drain perforating a lung lobe. Immediate recognition and aggressive treatment of this life-threatening condition should be provided in order to achieve a favorable outcome.

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疑似全身性气体栓塞与肺组织穿孔有关,该穿孔是由一只狗先前插入的胸腔引流管引起的。
目的:报告一例全身性气体栓塞,并在全身麻醉和间歇性正压通气下对一只狗进行胸骨切开术,取出穿过肺叶的胸腔引流管。病例总结:一只8岁的可卡犬通过正中胸骨切开术进行了探索性开胸术,用于脓胸的外科治疗,在双侧胸腔引流术后转诊前进行了7天的保守治疗。手术包括膈下纵隔切除术和心包切除术。在手术过程中,右侧引流管明显穿透了右中肺叶。引流管移除后出现突然的去饱和和快速的血液动力学恶化。根据临床症状和动脉血气分析结果,怀疑系统性气体栓塞,并立即开始支持性治疗,反应良好。手术完成后,在心脏听诊中可以听到清晰的“磨轮”声,护理点心脏超声证实心腔内存在气泡。这只狗从麻醉中恢复过来,在重症监护室接受治疗,动脉血气分析几乎正常,狗完全康复。提供的新的或独特的信息:在人身上,有与使用胸腔引流管有关的致命空气栓塞的报告。据我们所知,这是第一例因胸腔引流管穿透肺叶而导致犬在开胸手术中全身性气体栓塞的病例报告。应立即识别并积极治疗这种危及生命的情况,以获得有利的结果。
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来源期刊
CiteScore
2.50
自引率
15.40%
发文量
121
审稿时长
18-36 weeks
期刊介绍: The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.
期刊最新文献
Fabio Viganó Jennifer J. Devey Issue Information - Prelim AUTHOR INDEX Abstracts from the International Veterinary Emergency and Critical Care Symposium and the European Veterinary Emergency and Critical Care Annual Congress 2024
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