caa a22 4500 555311112 20190211030308.0 cr unu---uuuuu 190207e20180906xx s 000 0 eng 1751-0147 10.1186/s13028-018-0405-5 doi (BORIS)oai:boris.unibe.ch:124492 630 ddc 610 ddc 30189865 pmid Iatrogenic cerebral arterial gas embolism from flushing of the arterial line in two calves [Elektronische Daten] [Daniela Casoni, Alessandro Mirra, Christine Göpfert, Ilaria Petruccione, Claudia Spadavecchia] publishedVersion openAccess eu-repo BACKGROUND Measurement of invasive blood pressure as reflection of blood flow and tissue perfusion is often carried out in animals during general anesthesia. Intravascular cannulation offers the potential for gas to directly enter the circulation and lead to arterial gas embolism. Cerebral arterial gas embolism may cause a spectrum of adverse effects ranging from very mild symptoms to severe neurological injury and death. Although several experimental models of arterial gas embolism have been published, there are no known published reports of accidental iatrogenic cerebral arterial gas embolism from flushing of an arterial line in animals. CASE PRESENTATION A 7-day-old Red Holstein-Friesian calf (No. 1) and a 28-day-old Holstein-Friesian calf (No. 2) underwent hot iron disbudding and sham disbudding, respectively, under sedation and cornual nerve anesthesia. Invasive arterial blood pressure was measured throughout the procedure and at regular intervals during the day. Before disbudding, a sudden and severe increase of blood pressure was observed following flushing of the arterial line. Excitation, hyperextension of the limbs and rapid severe horizontal nystagmus appeared shortly thereafter. Over the following minutes, symptoms ameliorated and blood pressure normalized in both cases. Prompt diagnosis was missed in calf 1; supportive fluid therapy was provided. Severe deterioration of neurologic status occurred in the following 24h and culminated with stupor. The calf was euthanized for ethical reasons and the histological examination revealed extensive cerebral injury. Treatment of calf 2 consisted of supportive fluid and oxygen therapy; furosemide (1mg/kg IV) was injected twice. Calf 2 appeared clinically normal after 2h and showed no neurologic sequelae on a 3-month-follow up period. CONCLUSIONS There are no known reports of cerebral arterial gas embolism following flushing of the auricular arterial line in calves. The injection of a small amount of air at high pressure in a peripheral artery may lead to a significant cerebral insult. The clinical presentation is non-specific and can favour misdiagnosis and delay of therapy. Casoni Daniela joint author Mirra Alessandro joint author Göpfert Christine joint author Petruccione Ilaria joint author Spadavecchia Claudia joint author Acta Veterinaria Scandinavica 60(1), p. 51 1751-0147 https://boris.unibe.ch/124492/1/document.pdf text/html WWW-Backlink auf das Repository 1 info:eu-repo/semantics/article boris PeerReviewed boris peerstatus BORIS 856 40 https://boris.unibe.ch/124492/1/document.pdf text/html WWW-Backlink auf das Repository BORIS 700 1- Casoni Daniela joint author BORIS 700 1- Mirra Alessandro joint author BORIS 700 1- Göpfert Christine joint author BORIS 700 1- Petruccione Ilaria joint author BORIS 700 1- Spadavecchia Claudia joint author BORIS 773 0- Acta Veterinaria Scandinavica 60(1), p. 51 1751-0147 BK010053 XK010053 XK010000 BORIS BORIS BORIS info:eu-repo/semantics/article openAccess