Venous and paradoxical air embolism in the sitting position. A prospective study with transoesophageal echocardiography

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dc.contributor.authorPapadopoulos, G.en
dc.contributor.authorKuhly, P.en
dc.contributor.authorBrock, M.en
dc.contributor.authorRudolph, K. H.en
dc.contributor.authorLink, J.en
dc.contributor.authorEyrich, K.en
dc.date.accessioned2015-11-24T18:50:42Z
dc.date.available2015-11-24T18:50:42Z
dc.identifier.issn0001-6268-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/18132
dc.rightsDefault Licence-
dc.subjectAdulten
dc.subjectCerebellar Diseases/*surgery/ultrasonographyen
dc.subjectCerebellar Neoplasms/*surgery/ultrasonographyen
dc.subjectCervical Vertebrae/*surgery/ultrasonographyen
dc.subjectCranial Fossa, Posterior/surgery/ultrasonographyen
dc.subject*Echocardiography, Transesophagealen
dc.subjectEmbolism, Air/*ultrasonographyen
dc.subjectFemaleen
dc.subjectHeart Atria/ultrasonographyen
dc.subjectHeart Septal Defects, Atrial/complications/ultrasonographyen
dc.subjectHumansen
dc.subjectIntervertebral Disc Displacement/*surgery/ultrasonographyen
dc.subjectIntracranial Embolism and Thrombosis/*ultrasonographyen
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectMonitoring, Physiologicen
dc.subjectPosture/*physiologyen
dc.subjectRisk Factorsen
dc.titleVenous and paradoxical air embolism in the sitting position. A prospective study with transoesophageal echocardiographyen
heal.abstractThis 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.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/8042546-
heal.identifier.secondaryhttp://www.springerlink.com/content/rp4w0t1431u6100g/fulltext.pdf-
heal.journalNameActa Neurochir (Wien)en
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate1994-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

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