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Acta Neurochirurgica

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01-02-2017 | Original Article - Neurosurgical Techniques

Venous air embolism in the sitting position in cranial neurosurgery: incidence and severity according to the used monitoring

Authors: Franziska Günther, Paul Frank, Makoto Nakamura, Elvis Josef Hermann, Thomas Palmaers

Published in: Acta Neurochirurgica | Issue 2/2017

Abstract

Background

There is an ongoing debate about the sitting position (SP) in neurosurgical patients. The SP provides a number of advantages as well as severe complications such as commonly concerning venous air embolism (VAE). The best monitoring system for the detection of VAE is still controversial.

Methods

In this retrospective analysis we compared 208 patients. Transesophageal echocardiography (TEE) or transthoracic Doppler (TTD) were used as monitoring devices to detect VAE; 101 cases were monitored with TEE and 107 with TTD.

Results

The overall incidence of VAE was 23% (TTD: 10%; TEE: 37%), but the incidence of clinically relevant VAE (drop in end-tidal carbon dioxide above 3 mmHg) was higher in the TTD group (9 out of 17 VAE, 53%) compared to the TEE group (19 out of 62 VAE, 31%). None of the patients with recorded VAE had clinically significant sequelae.

Conclusions

In this small sample we found more VAE events in the TEE group, but the incidence of clinically relevant VAE was rare and comparable to other data. There is no consensus in the definition of clinically relevant VAE.

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Title: Venous air embolism in the sitting position in cranial neurosurgery: incidence and severity according to the used monitoring
Authors: Franziska Günther
Paul Frank
Makoto Nakamura
Elvis Josef Hermann
Thomas Palmaers
Publication date: 01-02-2017
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 2/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-3034-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Venous air embolism in the sitting position in cranial neurosurgery: incidence and severity according to the used monitoring

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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