127 KB35 KB192920262015Markovič Božič, JasminaPirc, NinaSpindler-Vesel, AlenkaVisočnik, Božidarletnik:84številka:9str. 599-608ISSN:1318-0347COBISSID:2558636URN:URN:NBN:SI:doc-R16YFSDXslSlovensko zdravniško društvoZdravniški vestnikair embolismcomplications of VAEincidence of VAEneurosurgical procedurenevrokirurški posegpogostost zračne embolijesedeči položajsitting positionzapleti zračne embolijezračna embolijaPogostost zračne embolije in zapleti po operaciji pri nevrokiruških posegih v sedečem položaju| Incidence of venous air emolism and postoperative complications in neurosurgery in sitting position|Background: Posterior fossa surgery and cervical spine surgery are at risk for venous air embolism (VAE) occurrence. Mostly air emboli are small and asymptomatic, but invasion of large quantity of air in the circulation is symptomatic and potentially lethal. Transesophageal echocardiography is the most sensitive method for detection of air emboli in the heart, followed by the precordial Doppler probe, end tidal carbon dioxide monitoring (etCO2) and others. Methods: In our 14- years retrospective review we evaluated the incidence of VAE and postoperative complications in patients with posterior fossa surgery or cervical spine surgery. VAE was recognized by using Doppler probe and/or drop of etCO2. If VAE occurred, aspiration of air through the CVC was used to prevent or to minimized VAE occurrence, the surgeon was warned about the incident. VAE treatment was supportive. Results: VAE was recognized in 74 patients. Two patients after head surgery and four patients after neck surgery needed postoperative treatment in intensive care unit and controled mechanical ventilation. In six patients after head surgery and in four patients after neck surgery new neurological symptoms occurred. Two patients after head surgery died due to complications of massive VAE. Conclusions: VAE is rare, but serious complication of neurosurgery in sitting position. Preventive treatment, early detection of VAE, supportive treatment and treatment of cardiovascular complications are necessary for survival of patients with VAETEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo