CPR in venous air embolism

Q: How chest compressions may help in venous air embolism even if patient has not lost a pulse?

Answer: The objective of the above question is to bring to light a less known intervention during venous air embolism where a patient may not lose pulse but become hemodynamically unstable. Technically called "closed chest cardiac massage" may help to force air out of the pulmonary outflow tract and into smaller pulmonary vessels, improving forward blood flow. 

In vitro studies suggest that closed-chest cardiac massage is as effective as left lateral decubitus position and intra-cardiac aspiration of air.


#hemodynamic


References:

1. Alvaran SB, Toung JK, Graff TE, Benson DW. Venous air embolism: comparative merits of external cardiac massage, intracardiac aspiration, and left lateral decubitus position. Anesth Analg 1978; 57:166. 

2. ERICSSON JA, GOTTLIEB JD, SWEET RB. CLOSED-CHEST CARDIAC MASSAGE IN THE TREATMENT OF VENOUS AIR EMBOLISM. N Engl J Med 1964; 270:1353.