Re: [問題] 可以請教一下體內空氣的問題嗎~"~...

[spicy (loma~loma~ya)]

※ 引述《triticeal (triticeal cartilage)》之銘言：
: 因為感覺我關鍵字抓不對...
: 結果一直找不到相關的資料
: 想問一下前輩
: 打iv時有時候不小因會把空氣打進去，這個空氣應該有個最大量限制吧？大概是多少？
: (可以的話也可以提供我關鍵字...)
: 另外如果是做Rubin test，我找不到到底該注入多少co2為上限。
: 不知道能不能稍微指點一下...感謝！


=====================================================
1.
http://qjmed.oxfordjournals.org/content/98/3/231.full

裡面提到: (抱歉我沒學標顏色 @@)

In humans, the fatal dose is "uncertain" but is estimated as " 200–300cc."
A much lower volume can prove fatal if a right-to-left shunt allows air to
bypass the lungs and enter the systemic circulation...

至於其中200~300 ml的出處從http://www.ncbi.nlm.nih.gov/pubmed/11176104來


2.
http://emedicine.medscape.com/article/761367-overview
可以自己仔細看看
裡面可以看到重點有:

(2a)
The key factors determining the degree of morbidity and mortality in venous
air emboli are related to
~~the volume of gas entrainment,
~~the rate of accumulation, and
~~the patient’s position at the time of the event.

為什麼說是重點?因為致死體積會受到上述因素影響~

(2b)
Traditionally, it has been estimated that more than 5 mL/kg of air displaced
                           ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
into the intravenous space is required for significant injury (shock or
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
cardiac arrest) to occur.However, complications have been reported with as
little as 20 mL of air (the length of an unprimed IV infusion tubing) that
was injected intravenously....


個人結論:一般週邊IV而言，10ml 的空氣應該還算是相當安全的

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推 JohnH:有一本古早的英國偵探小說有說  注入10c.c.可以殺人
→ JohnH:我猜"10cc"是從這來的  但我忘記是哪本書了 只記得是英國
推 triticeal:真是不知道怎麼表示感激><...
推 pipiann:http://emedicine.medscape.com/article/761367-overview
→ pipiann:要查就查VAE~~Miller's寫0.5ml/kg
→ spicy:樓上你的連結不是跟我貼的一樣嗎 =  =
→ spicy:查很多文獻都是預估要200ml以上甚至是300~500ml
→ spicy:所以你說MILLER寫0.5ml/kg ...有點怪怪的
→ spicy:方便附上出處或文字嗎?
→ spicy:另外我要再次強調，我文中也提過了，致死劑量受許多因素影響
→ spicy:不知道你說的0.5ml/kg這劑量是可能出現minor complication?
→ spicy:或這是lethal dose?
→ spicy:另外根據  American Society of Anesthesiologists
→ spicy:2001 Feb;94(2):360-1
→ spicy:"Volume of Air in a Lethal Venous Air Embolism"中
→ spicy:The lethal volume of air in an adult human is unknown bu
→ spicy:-t is estimated to range from 200 to 300 ml.
→ spicy:查到幾個說法fatal amount 幾乎都是 3~5 ml/kg ~