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Multiple cerebral infarction and paradoxical air embolism during hepatectomy using the Cavitron Ultrasonic Surgical Aspirator -A case report-.

 Jae Hoon Lee  ;  Tae Dong Kwon  ;  Hyun Joo Kim  ;  Byoungchan Kang  ;  Bon-Nyeo Koo 
 Korean Journal of Anesthesiology, Vol.59(suppl) : 133-136, 2010 
Journal Title
 Korean Journal of Anesthesiology 
Issue Date
Hepatectomy ; Liver disease ;  Paradoxical embolism
A venous air embolism and paradoxical air embolism (PAE) are serious complications in patients undergoing a hepatectomy. We report a case of PAE and cerebral infarctions in a patient undergoing a hepatic resection using a Cavitron Ultrasonic Surgical Aspirator (CUSA®). A 65-year-old woman underwent a left lobe hepatectomy. During the middle phase of the liver resection with CUSA®, there was a sudden decrease in arterial blood pressure, end-tidal carbon dioxide and SpO(2). With resuscitation, intraoperative ultrasonography revealed massive air emboli in both her left and right heart, which lasted for 40 min. The hepatectomy was completed after the disappearance of the air emboli from her heart. After surgery, her mental status was stuporous. The brain CT and MRI revealed multiple acute cerebral infarctions. Finally, she died from septic shock. This case highlights the need for anesthetists and surgeons to be aware of the potential for CUSA®-related massive PAE.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koo, Bon-Nyeo(구본녀) ORCID logo https://orcid.org/0000-0002-3189-1673
Kweon, Tae Dong(권태동) ORCID logo https://orcid.org/0000-0002-5451-1856
Kim, Hyun Joo(김현주C)
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
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