Pulmonary gas embolism as a potential cause of hypoxia immediately after cardiopulmonary bypass

摘要

THE DEVELOPMENT OF HYPOXIA is not uncommon during cardiac surgery. Causes of hypoxia include cardio-genic and/or noncardiogenic pulmonary edema, atelectasis, pneumonia, surgical trauma of pulmonary vasculatures, and increased ventilation-perfusion (V_A/Q) mismatch from vasodilators. Pulmonary gas embolism (PGE) by air or medical gases potentially can occur in cardiac surgery involving opening of the right heart because it is impossible to remove all traces of air from the cardiac chambers before closing the heart. However, PGE has not been mentioned often as a cause of hypoxia during cardiac surgery. An adult patient who underwent corrective surgery for incomplete endocardial cushion defect (ECD) and developed severe hypoxia immediately after cardiopulmonary bypass (CPB), in which case the authors hypothesized PGE as a possible cause, is presented.