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Air embolism in liver surgery...Very interesting



Air embolism is  common complication during liver surgery specially when you are maintainig low CVP.

The Cavitron ultrasonic aspirator (CUSA) is associated with less blood loss  than is a clamp-and-crush method.

However, all CUSA patients had air emboli during hepatectomy.Air emboli occurred in 68% of patients undergoing clampand- crush hepatic resection.

Air embolism is problematic during liver surgery and transplantation because of the risk of catastrophic paradoxical embolism.

Paradoxical embolism need not occur through an intracardiac right-to-left defect. Many patients presenting for hepatic resection (and certainly most liver transplant
patients) have cirrhosis, and many cirrhotic patients have abnormal arteriovenous connections in the pulmonary circulation.

Massive venous embolism and/or paradoxical embolus must be high on the differential diagnosis of unexplained cardiopulmonary performance problems during hepatic resection

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