Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP)

Zhang Wangping; Ren Ming

doi:doi:10.11648/j.sjcm.20170604.13

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Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP)

Zhang Wangping, Ren Ming

Published in Science Journal of Clinical Medicine (Volume 6, Issue 4)

Received: 15 January 2017 Accepted: 17 February 2017 Published: 18 October 2017

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Abstract

Massive air embolism occured during holmium laser enucleation of the prostate (HOLEP) for prostatic hyperplasia (BPH). A 65 years patient with BPH was scheduled to undergo elective HoLEP. After anesthetic of intrathecal 15 mg hyperbaric ropivocaine was administered in the left lateral decubitus position, then the patient was turned in supine position. The surgery started when the patient was placed in a 10 degree head down tilt. Two hours and 40 min later, while the hypertrophic prostate was almost enucleated, the patient complained of abdominal distension. Immediately, he was not breathing and his eyes were glazed. The heart rate abruptly decreased from 82 to 35 beats per min and cardiac arrest happened. After intubation, it showed the end-tidal carbon dioxide partial pressure (PetCO₂) was 6 mmHg. When took a blood sample from external jugular vein for blood gas analysis, some air existed in the syringe. VAE was suspected.

Published in	Science Journal of Clinical Medicine (Volume 6, Issue 4)
DOI	10.11648/j.sjcm.20170604.13
Page(s)	60-62
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Air Embolism, Holmium Laser, Prostate

References

[1]	Aho TF. Holmium laser enucleation of the prostate: a paradigm shift in benign prostatic hyperplasia surgery. Ther Adv Urol 2013, 5: 245-53.
[2]	Kato TI, Sugimoto M, Matsuoka Y, et al. Case of vascular air embolism during holmium laser enucleation of the prostate. Int J Urol 2014, 13.
[3]	Vacanti CA, Lodhia KL. Fatal massive air embolism during transurethral resection of the prostate. Anesthesiology 1991, 74: 186-7.
[4]	Albin MS, Carroll RG, Maroon JC. Clinical considerations concerning detection of venous air embolism. Neurosurgery 1978, 3: 380-4.
[5]	Albin MS, Ritter RR, Reinhart R, et al. Venous air embolism during radical retropubic prostatectomy. Anesth Analg 1992, 74: 151-3.
[6]	Memtsoudis SG, Malhotra V. Catastrophic venous air embolus during prostatectomy in the Trendelenburg position. Can J Anaesth 2003, 50: 1084-5.
[7]	Tsou MY, Teng YH, Chow LH, et al. Fatal gas embolism during transurethral incision of the bladder neck under spinal anesthesia. Anesth Analg. 2003, 97: 1833-4.
[8]	Toung TJ, Rossberg MI, Huthins GM. Volume of air in a lethal venous air embolism. Anesthesiology 2001, 94: 360-1.
[9]	Presson RG, Kirk KR, Haselby KA, et al. Fate of air emboli in the pulmonary circulation. J Appl Physiol 1989, 67: 1898–902.
[10]	Frasco PE, Caswell RE, Novicki D. Venous air embolism during transurethral resection of the prostate. Anesth Analg 2004, 99: 1864-6.
[11]	Kato T, Sugimoto M, Matsuoka Y, et al. Case of vascular air embolism during holmium laser enucleation of the prostate. Int J Urol. 2015, 22: 227-9.
[12]	Vacanti CA, Lodhia KL. Fatal massive air embolism during transurethral resection of the prostate. Anesthesiology 1991, 74: 186-7.
[13]	Chang CP, Liou CC, Yang YL, et al. Fatal gas embolism during ureteroscopic holmium: yttrium-aluminium-garnet laser lithotripsy under spinal anesthesia - a case report. Minim Invasive Ther Allied Technol 2008, 17: 259-61.
[14]	Tsou MY, Teng YH, Chow LH, et al. Fatal gas embolism during transurethral incision of the bladder neck under spinal anesthesia. Anesth Analg. 2003, 97: 1833-4.
[15]	Hong JY, Kim JY, Choi YD, et al. Incidence of venous gas embolism during robotic-assisted laparoscopic radical prostatectomy is lower than that during radical retropubic prostatectomy. Br J Anaesth 2010, 105: 777-81.

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APA Style

Zhang Wangping, Ren Ming. (2017). Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP). Science Journal of Clinical Medicine, 6(4), 60-62. https://doi.org/10.11648/j.sjcm.20170604.13

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ACS Style

Zhang Wangping; Ren Ming. Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP). Sci. J. Clin. Med. 2017, 6(4), 60-62. doi: 10.11648/j.sjcm.20170604.13

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AMA Style

Zhang Wangping, Ren Ming. Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP). Sci J Clin Med. 2017;6(4):60-62. doi: 10.11648/j.sjcm.20170604.13

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@article{10.11648/j.sjcm.20170604.13,
  author = {Zhang Wangping and Ren Ming},
  title = {Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP)},
  journal = {Science Journal of Clinical Medicine},
  volume = {6},
  number = {4},
  pages = {60-62},
  doi = {10.11648/j.sjcm.20170604.13},
  url = {https://doi.org/10.11648/j.sjcm.20170604.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20170604.13},
  abstract = {Massive air embolism occured during holmium laser enucleation of the prostate (HOLEP) for prostatic hyperplasia (BPH). A 65 years patient with BPH was scheduled to undergo elective HoLEP. After anesthetic of intrathecal 15 mg hyperbaric ropivocaine was administered in the left lateral decubitus position, then the patient was turned in supine position. The surgery started when the patient was placed in a 10 degree head down tilt. Two hours and 40 min later, while the hypertrophic prostate was almost enucleated, the patient complained of abdominal distension. Immediately, he was not breathing and his eyes were glazed. The heart rate abruptly decreased from 82 to 35 beats per min and cardiac arrest happened. After intubation, it showed the end-tidal carbon dioxide partial pressure (PetCO2) was 6 mmHg. When took a blood sample from external jugular vein for blood gas analysis, some air existed in the syringe. VAE was suspected.},
 year = {2017}
}

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TY  - JOUR
T1  - Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP)
AU  - Zhang Wangping
AU  - Ren Ming
Y1  - 2017/10/18
PY  - 2017
N1  - https://doi.org/10.11648/j.sjcm.20170604.13
DO  - 10.11648/j.sjcm.20170604.13
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 60
EP  - 62
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20170604.13
AB  - Massive air embolism occured during holmium laser enucleation of the prostate (HOLEP) for prostatic hyperplasia (BPH). A 65 years patient with BPH was scheduled to undergo elective HoLEP. After anesthetic of intrathecal 15 mg hyperbaric ropivocaine was administered in the left lateral decubitus position, then the patient was turned in supine position. The surgery started when the patient was placed in a 10 degree head down tilt. Two hours and 40 min later, while the hypertrophic prostate was almost enucleated, the patient complained of abdominal distension. Immediately, he was not breathing and his eyes were glazed. The heart rate abruptly decreased from 82 to 35 beats per min and cardiac arrest happened. After intubation, it showed the end-tidal carbon dioxide partial pressure (PetCO2) was 6 mmHg. When took a blood sample from external jugular vein for blood gas analysis, some air existed in the syringe. VAE was suspected.
VL  - 6
IS  - 4
ER  -

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Author Information

Zhang Wangping

Department of Anesthesiology, Affiliated Women and Children’S Hospital of Jiaxing University, Jiaxing, China
Ren Ming

Department of Anesthesiology, Affiliated Women and Children’S Hospital of Jiaxing University, Jiaxing, China

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Plain Text BibTeX RIS

APA Style

Zhang Wangping, Ren Ming. (2017). Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP). Science Journal of Clinical Medicine, 6(4), 60-62. https://doi.org/10.11648/j.sjcm.20170604.13

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ACS Style

Zhang Wangping; Ren Ming. Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP). Sci. J. Clin. Med. 2017, 6(4), 60-62. doi: 10.11648/j.sjcm.20170604.13

Copy | Download

AMA Style

Zhang Wangping, Ren Ming. Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP). Sci J Clin Med. 2017;6(4):60-62. doi: 10.11648/j.sjcm.20170604.13

Copy | Download

@article{10.11648/j.sjcm.20170604.13,
  author = {Zhang Wangping and Ren Ming},
  title = {Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP)},
  journal = {Science Journal of Clinical Medicine},
  volume = {6},
  number = {4},
  pages = {60-62},
  doi = {10.11648/j.sjcm.20170604.13},
  url = {https://doi.org/10.11648/j.sjcm.20170604.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjcm.20170604.13},
  abstract = {Massive air embolism occured during holmium laser enucleation of the prostate (HOLEP) for prostatic hyperplasia (BPH). A 65 years patient with BPH was scheduled to undergo elective HoLEP. After anesthetic of intrathecal 15 mg hyperbaric ropivocaine was administered in the left lateral decubitus position, then the patient was turned in supine position. The surgery started when the patient was placed in a 10 degree head down tilt. Two hours and 40 min later, while the hypertrophic prostate was almost enucleated, the patient complained of abdominal distension. Immediately, he was not breathing and his eyes were glazed. The heart rate abruptly decreased from 82 to 35 beats per min and cardiac arrest happened. After intubation, it showed the end-tidal carbon dioxide partial pressure (PetCO2) was 6 mmHg. When took a blood sample from external jugular vein for blood gas analysis, some air existed in the syringe. VAE was suspected.},
 year = {2017}
}

Copy | Download

TY  - JOUR
T1  - Fatal Massive Air Embolism During Holmium Laser Enucleation of the Prostate (HoLEP)
AU  - Zhang Wangping
AU  - Ren Ming
Y1  - 2017/10/18
PY  - 2017
N1  - https://doi.org/10.11648/j.sjcm.20170604.13
DO  - 10.11648/j.sjcm.20170604.13
T2  - Science Journal of Clinical Medicine
JF  - Science Journal of Clinical Medicine
JO  - Science Journal of Clinical Medicine
SP  - 60
EP  - 62
PB  - Science Publishing Group
SN  - 2327-2732
UR  - https://doi.org/10.11648/j.sjcm.20170604.13
AB  - Massive air embolism occured during holmium laser enucleation of the prostate (HOLEP) for prostatic hyperplasia (BPH). A 65 years patient with BPH was scheduled to undergo elective HoLEP. After anesthetic of intrathecal 15 mg hyperbaric ropivocaine was administered in the left lateral decubitus position, then the patient was turned in supine position. The surgery started when the patient was placed in a 10 degree head down tilt. Two hours and 40 min later, while the hypertrophic prostate was almost enucleated, the patient complained of abdominal distension. Immediately, he was not breathing and his eyes were glazed. The heart rate abruptly decreased from 82 to 35 beats per min and cardiac arrest happened. After intubation, it showed the end-tidal carbon dioxide partial pressure (PetCO2) was 6 mmHg. When took a blood sample from external jugular vein for blood gas analysis, some air existed in the syringe. VAE was suspected.
VL  - 6
IS  - 4
ER  -

Copy | Download