Analysis of clinical implications of aeroembolism during cerebello-pontine angle tumor removal conducted in semi-sitting position
Journal Title: Annales Academiae Medicae Silesiensis - Year 2014, Vol 68, Issue 5
Abstract
BACKGROUND The semi-sitting position of the patient during cerebellopontine angle (CPA) surgery enables the spontaneous outflow of blood and cerebrospinal fluid from the operation area. This restricts the necessity of using an aspirating nozzle and other instruments which are dangerous for local delicate structures like the facial nerve or labyrinthine artery. The disadvantage of the semi-sitting position is the risk of pneumatocele and aeroembolism. METHODS 214 patients operated on in the Department of Neurosurgery, Medical University of Silesia in Katowice were analyzed. Aeroembolism was correlated with such parameters as: perioperative death rate, duration of hospitalization in neurosurgical and intensive care wards, respiratory or circulatory insufficiency, necessity of using a respirator and the number of specialist consultations RESULTS Aeroembolism does not increase the death rate or duration of hospitalization in a neurosurgical ward, but it does expose patients to respiratory failure (p = = 0.014). Aeroembolism is also correlated with hospitalization in an intensive care ward (p = 0.002) and increases the number of specialist consultations (p = = 0.042). In our opinion, very important for the prevention of aeroembolism is surgeons’ care on the closure of every open vein , especially those in bone, using bone wax. The elevation of venous pressure due to manual compression on the cervical veins is the best method for locating not bleeding but open veins. CONCLUSIONS We have proved that a venous air embolism increases neither mortality nor the duration of hospitalization. We believe that prevention and early treatment of aeroembolism prevents further complications.
Authors and Affiliations
Stanisław Kwiek, Krzysztof Suszyński, Hanna Doleżych, Izabela Duda, Aneta Orczyk, Agata Rauszer, Damian Kocur, Piotr Bażowski
Keywords
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