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Bunegin-Albin Catheter Improves Air Retrieval and Resuscitation from Lethal Venous Air Embolism in Upright Dogs

Department of Anesthesiology, University of Washington, Seattle, Washington.

Abstract

Three types of catheters, the Arrow® multi-orifice catheter, the American Edwards 7 Fr Swan-Gam® catheter and the Cook® Bunegin-Albin multi-orifice CVP catheter were evaluated for their ability to retrieve venous air emboli and effect on the success rate of resuscitation from venous air emboli. The catheters were inserted in dogs anesthetized with isoflurane (1.7%, inspired) and N₂O (66%) in O₂ and placed in the sitting position with the head 90 to the horizontal. Swan-Ganz® catheters were positioned with the right atrial (RA) port just above the junction of the superior vena cava (SVC) and the RA and the pulmonary artery (PA) port in the pulmonary artery. The Arrow® and Bunegin-Albin multi-orifice catheters were placed with the proximal orifice just above the SVC-RA junction and the distal orifice near the mid-RA. Dogs were then given a predetermined lethal dose of air (5 ml kg^–1) over 30 sec via the jugular vein. Attempts to aspirate venous air emboli were begun with the first decrease in expired CO₂. Both RA and PA ports of the Swan-Gam® catheter were used for aspiration. The amounts of gas retrieved expressed as a percent of the injected air and the incidence of successful resuscitation were compared. Significantly greater percentages of injected venous air were retrieved with the Bunegin-Albin catheter (63 ± 14%, mean ± SEM) than with the Arrow® multi-orifice catheter (6 ± 2%) or the Swan-Ganz® catheter (14 ± 5%). The success rate of resuscitation was significantly greater with the Bunegin-Albin catheter (4 of 6 dogs) than with either the Arrow® catheter or the Swan-Ganz® catheter, (1 of 6 in both groups). The Cook ® Bunegin-Albin multi-orifice catheter appears to be superior to the Arrow® multi-orifice catheter or the Swan-Ganz® catheter for aspiration of venous air in dogs placed in the sitting position.

Key Words: EMBOLISM, air

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