Venous and paradoxical air embolism in the sitting position. A prospective study with transoesophageal echocardiography
Φόρτωση...
Ημερομηνία
Συγγραφείς
Papadopoulos, G.
Kuhly, P.
Brock, M.
Rudolph, K. H.
Link, J.
Eyrich, K.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Acta Neurochir (Wien)
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
This prospective study investigates the frequency of patent foramen ovale (PFO), venous air embolism (VAE) and paradoxical air embolism (PAE) by transoesophageal echocardiography (TOE) in neurosurgical patients operated on in the sitting position. The risk of PAE after exclusion of PFO is assessed. A PFO was identified by pre-operative TOE and VAE and PAE by continuous intraoperative TOE. Sixty-two patients were divided into two groups, 22 patients were studied in group 1 (posterior fossa surgery) and group 2 (cervical surgery) contained 40 patients. Pre-operative TOE demonstrated a PFO in 5 of the 22 patients in group 1 (23%). Patients with proven PFO were excluded from the sitting position. Two further patients of this group (12% of 17 patients), in whom a PFO had been excluded pre-operatively, nevertheless had PAE, air occurring in all cavities of the heart. In group 2 the incidence of PFO was 4 out of 40 patients (10%). No PAE was observed in this group. Three morphological types of VAE with different haemodynamic and ventilation changes were demonstrated. VAE was observed in 76% of all posterior fossa operations and in 25% of cervical laminectomies. We conclude that a pre-operative search for PFO is mandatory considering its incidence of 23% in group 1 and of 10% in group 2, and the risk of PAE. If a PFO is detected, the sitting position should be avoided. A residual risk for PAE remains despite exclusion of PFO because the reliability of TOE is limited. TOE is the method of choice for detecting VAE and PAE.
Περιγραφή
Λέξεις-κλειδιά
Adult, Cerebellar Diseases/*surgery/ultrasonography, Cerebellar Neoplasms/*surgery/ultrasonography, Cervical Vertebrae/*surgery/ultrasonography, Cranial Fossa, Posterior/surgery/ultrasonography, *Echocardiography, Transesophageal, Embolism, Air/*ultrasonography, Female, Heart Atria/ultrasonography, Heart Septal Defects, Atrial/complications/ultrasonography, Humans, Intervertebral Disc Displacement/*surgery/ultrasonography, Intracranial Embolism and Thrombosis/*ultrasonography, Male, Middle Aged, Monitoring, Physiologic, Posture/*physiology, Risk Factors
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/8042546
http://www.springerlink.com/content/rp4w0t1431u6100g/fulltext.pdf
http://www.springerlink.com/content/rp4w0t1431u6100g/fulltext.pdf
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής