Abstract
The use of pulmonary arterial pressure (PAP) monitoring was compared with precordial Doppler ultrasound monitoring and continuous infrared end-tidal CO2 fraction (FET(CO2)) analysis for detection and treatment of venous air embolism in 52 consecutive patients undergoing neurosurgical procedures in the seated position. Doppler air sounds were identified 44 times during 20 operations. During 12 operations there were 17 episodes of Doppler air sounds associated with increased PAP (mean increase = 13 ± 2.8 torr SE,P<.001), lasting for an average of 7±2 min (SE). Only small volumes (2-20 ml) of air were recovered from the pulmonary artery and right atrium via the pulmonary-artery catheter during periods of increased PAP. During 12 episodes when PAP was increased, mean FET(CO2) decreased, from 3.8±.2 to 2.7±.3% (SE), P<.05. Monitoring of PAP afforded prompt diagnosis of clinically significant air embolism and an estimate of the severity of the condition, usually before systemic circulatory changes occurred. Monitoring of PAP also indicated when it seemed prudent to continue the surgical procedure after air embolism and when surgical intervention had corrected the cause of air entrainment. Although successful pulmonary arterial catheterization was not possible in five patients, no significant complication resulted from the procedure in this series. The authors believe that monitoring of PAP for detection and treatment of air embolism is justified during seated neurosurgical procedures.
Original language | English (US) |
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Pages (from-to) | 131-134 |
Number of pages | 4 |
Journal | Anesthesiology |
Volume | 52 |
Issue number | 2 |
State | Published - 1980 |
All Science Journal Classification (ASJC) codes
- Anesthesiology and Pain Medicine