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Beware of Air in the Blood Pump

Breen, P, Hong, A. Beware of Air in the Blood Pump. Anesth Analg. 2000; 91(4):1038.

Letter to the Editor

Air embolism can complicate peripheral IV fluid therapy (1) or central venous catheter monitoring, including problems with IV infusion pumps (2), improper flushing of IV sets (3), incorrect injection of drugs into the infusion system (3), and accidental disconnection of the hub or removal of central venous catheters (4). Air embolism can cause blockage of small vessels in the pulmonary vasculature with compromise of gas exchange, cessation of ventricular pumping caused by blockage by air and arrhythmia (5), and paradoxical air embolism to the systemic circulation through a probe-patent foramen ovale (6). We describe a complication with an IV blood pump infusion set, with potential for air embolism.

Y-type IV infusion blood pump sets are commonly used during anesthesia administration (Fig. 1). Typically, one arm of the Y is attached to a bag of crystalloid fluid. Often, the other infusion arm dangles unused, and its roller valve B is closed. Fluid flow rate should be controlled with the lower roller valve C (manufacturer’s recommendation).

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