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1 results

  • Case 15 - Awakefiberoptic intubation

  • from Section I - Neuroanesthesia
  • Edited by George A. Mashour, Ehab Farag
  • Book:
    Case Studies in Neuroanesthesia and Neurocritical Care
    Published online:
    03 May 2011
    Print publication:
    03 February 2011, pp 48-50

  • Summary

    A venous air embolism (VAE) is a potentially life-threatening event caused by air in the vascular system. The entrainment of air from an operative site into the venous vasculature produces a wide array of systemic effects. This chapter presents a case study of a 37-year-old female with a right-sided acoustic neuroma presenting for a suboccipital approach to tumor resection. VAE was historically most often associated with craniotomies performed in the sitting position. Clinical presentation depends on the severity of the air embolus. There are several monitors that are capable of detecting venous air emboli. The most sensitive is transesophageal echocardiography (TEE). The presence of TEE also enables direct visualization of air aspiration through a central catheter if a VAE should occur. Monitors for high-risk cases should be chosen depending on the expertise of the anesthesiologist, the surgery being performed, and the position of the patient.