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Air embolism and its treatment by the intravenous injection of a carbon suspension
1166
AMERICAN
Duchosal, P. W., Intracardiac 1948.
Ferrero, Potentials
C.,
Doret, Obtained
HEART
JOURNAL
J. P., Andereggen, by Catheterization.
P.,
and
Rilliet, Cardiologia
B.:
The 13:113
Human (No. 3),
Three standard leads were taken simultaneously with the intracardiac potential by means of a four-channel electrocardiograph. The right arm was used as the site of the indifferent electrode for the intracavitary leads. Tracings were obtained in nineteen patients and one normal subject. The potentials of the right atrium and ventricle are from 0.5 to 3.0 millivolts for the former, and from 8.0 to 30 millivolts for the latter. The size of the QRS complex diminishes considerably as soon as the electrode leaves the ventricle; the voltage of the P wave falls when the electrode is outside the auricle. The intra-auricular P wave never begins earlier than the P wave of the standard leads. The P wave obtained from the inside of the left auricle in a case of interauricular septal defect was positive and late. In auricular fibrillation, the intra-auricular leads sometimes show large, well-marked, regularly recurring auricular oscillations during periods of as long as two seconds; between these periods the oscillations are small and irregular. From this behavior one may conclude that interference of several components plays a role in this arrhythmia. The ventricular In cases R wave. to 0.10 second.
tracing of right
obtained from bundle branch
inside block
the right ventricle usually the intrinsicoid deflection
begins with a small is delayed from 0:04
The majority of the premature contractions observed during the catheterization are ventricular. Their voltage is usually higher than that of the normotopic systoles and they originate in the right ventricle as evidenced by the immediate negativity of their QRS complex. Before the first signs of the presence of the extrasystole appear in the standard leads the intraventricular activity may already exist for 0.03 second and attain an amplitude of 10 millivolts. This fact is of considerable importance in confirming the theory of the distribution of electrical potentials of the heart to the periphery. BRUMLIK.
DeCastro, venous
G. L., and Injection
Carrascal, A. F.: Air of a Carbon Suspension.
Embolism Rev.
and Clin.
Its Treatment Espafi. 28:215
by the (Feb.),
Intra1948.
The authors review the literature on air embolism and report two cases that developed severe cerebral manifestations with loss of consciousness and convulsive seizures following therapeutic pneumothorax. The first patient died while the second one recovered promptly after the intravenous injection of 2.0 to 3.0 cc. of a fine suspension of carbon. This preparation serves to absorb the free gas and thus relieves the symptoms produced by the mechanical obstruction to blood flow in either the greater or lesser circulation. The carbon suspension should be injected slowly and a paraffinated syringe is required to prevent settling of the preparation. The authors without success. ments also failed
attempted to reproduce their single clinical cure experimentally The animals died too quickly following the injection of air. to demonstrate the value of carbon suspension.
“In
in six rabbits vitro” experiGOLD.
AMERICAN
Duchosal, P. W., Intracardiac 1948.
Ferrero, Potentials
C.,
Doret, Obtained
HEART
JOURNAL
J. P., Andereggen, by Catheterization.
P.,
and
Rilliet, Cardiologia
B.:
The 13:113
Human (No. 3),
Three standard leads were taken simultaneously with the intracardiac potential by means of a four-channel electrocardiograph. The right arm was used as the site of the indifferent electrode for the intracavitary leads. Tracings were obtained in nineteen patients and one normal subject. The potentials of the right atrium and ventricle are from 0.5 to 3.0 millivolts for the former, and from 8.0 to 30 millivolts for the latter. The size of the QRS complex diminishes considerably as soon as the electrode leaves the ventricle; the voltage of the P wave falls when the electrode is outside the auricle. The intra-auricular P wave never begins earlier than the P wave of the standard leads. The P wave obtained from the inside of the left auricle in a case of interauricular septal defect was positive and late. In auricular fibrillation, the intra-auricular leads sometimes show large, well-marked, regularly recurring auricular oscillations during periods of as long as two seconds; between these periods the oscillations are small and irregular. From this behavior one may conclude that interference of several components plays a role in this arrhythmia. The ventricular In cases R wave. to 0.10 second.
tracing of right
obtained from bundle branch
inside block
the right ventricle usually the intrinsicoid deflection
begins with a small is delayed from 0:04
The majority of the premature contractions observed during the catheterization are ventricular. Their voltage is usually higher than that of the normotopic systoles and they originate in the right ventricle as evidenced by the immediate negativity of their QRS complex. Before the first signs of the presence of the extrasystole appear in the standard leads the intraventricular activity may already exist for 0.03 second and attain an amplitude of 10 millivolts. This fact is of considerable importance in confirming the theory of the distribution of electrical potentials of the heart to the periphery. BRUMLIK.
DeCastro, venous
G. L., and Injection
Carrascal, A. F.: Air of a Carbon Suspension.
Embolism Rev.
and Clin.
Its Treatment Espafi. 28:215
by the (Feb.),
Intra1948.
The authors review the literature on air embolism and report two cases that developed severe cerebral manifestations with loss of consciousness and convulsive seizures following therapeutic pneumothorax. The first patient died while the second one recovered promptly after the intravenous injection of 2.0 to 3.0 cc. of a fine suspension of carbon. This preparation serves to absorb the free gas and thus relieves the symptoms produced by the mechanical obstruction to blood flow in either the greater or lesser circulation. The carbon suspension should be injected slowly and a paraffinated syringe is required to prevent settling of the preparation. The authors without success. ments also failed
attempted to reproduce their single clinical cure experimentally The animals died too quickly following the injection of air. to demonstrate the value of carbon suspension.
“In
in six rabbits vitro” experiGOLD.