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Chapter 43 - Venous Air Embolism

from Section 3 - Neuroanesthesia

Published online by Cambridge University Press:  03 August 2023

By
Brian M. Osman
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 77-year-old, 120 kg female presents for a craniotomy and resection of her posterior fossa tumor. The surgeon prefers her to be placed in the sitting position for the operation. She has a medical history significant for diabetes (DM), hypertension (HTN), congestive heart failure (CHF), and gastroesophageal reflux disease (GERD). She is a nonsmoker with unknown exercise tolerance due to her decreased mobility secondary to osteoarthritis (OA) of her knees. What pre-operative labs and studies would you like? What monitors will you use? Should the procedure be done in the sitting position? Is venous air embolism (VAE) a concern? Will you use N2O? How would you identify a VAE? Can you prevent a VAE? How would you treat a VAE?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 192 - 196
Publisher: Cambridge University Press
Print publication year: 2023

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References

Barash, PG, Cullen, BF, Stoelting, RK, et al. Clinical Anesthesia, 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2017, pp. 1016–18, 1271–2.Google Scholar
Black, S, Ockert, DB, Oliver, WC, Cucchiara, RF. Outcome following posterior fossa craniectomy in patients in the sitting or horizontal positions. Anesthesiology 1988;69:49–56.CrossRefGoogle ScholarPubMed
Gropper, MA. Miller’s Anesthesia, 9th ed. Philadelphia: Elsevier, 2020, pp. 1868–910.Google Scholar
Murray, M, Harrison, B, Mueller, JT. Faust’s Anesthesiology Review, 4th ed. Philadelphia: Saunders, 2015 pp. 322–4.Google Scholar
Schubert, A. Clinical Neuroanesthesia. Newton: Butterworth-Heinemann, 1997, pp. 363–72.Google Scholar

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