Venous air embolism: comparative merits of external cardiac massage, intracardiac aspiration, and left lateral decubitus position

The treatment of venous air embolism was compared in adult mongrel dogs utilizing left lateral decubitus position, external cardiac massage, and intracardiac aspiration of air. Following the rapid injection of a lethal dose (15 ml/kg) of air, it was found that the left lateral decubitus position and external cardiac massage each produced 57.1 percent survival, both being as effective as intracardiac aspiration of air (61.9 percent survival). Resuscitation time was shortest in dogs treated with intracardiac aspiration, 2.7 +/- 0.28 minutes, whereas with external cardiac massage and left lateral decubitus position, resuscitation times were 18.3 +/- 2.1 minutes and 19.50 +/- 3.0 minutes, respectively. Our study shows external cardiac massage, left lateral decubitus position, and intracardiac aspiration to be equally effective in the treatment of venous air embolism. Our data did not show intracardiac aspiration to be superior to either external cardiac massage of left lateral decubitus position despite the shorter resuscitation time. External cardiac massage has the advantage of simplicity and speed of initiation.