Massive Air Embolism at the Initiation of Cardiopulmonary Bypass: Case Report

Massive air embolism (MAE) occurs in 0.1-0.2 % of patients undergoing cardiopulmonary bypass, and approximately half of these patients suffer permanent neurologic damage or death. Large amounts of air may enter the perfusion system via many different portals. Immediate deep hypothermia and the administration of brain protective agents have been used to prevent the permanent sequelae of MAE (1). Use and efficacy of retrograde cerebral perfusion through the superior vena cava have been reported for the treatment of cerebral air embolism during cardiopulmonary bypass (CPB) (2). We report the successful management of an accidental MAE at the initiation of CPB.