Echocardiographic detection and treatment of intraoperative air embolism

S. Sato, S. Toya, T. Ohira, T. Mine, N. H. Greig

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

A real-time two-dimensional echocardiogram was used to detect the presence of an air embolism in patients undergoing neurosurgical procedures in the sitting position. The technique could with good sensitivity detect the appearance of a single air bubble intraoperatively, thus allowing early intervention to prevent development of further air emboli. Two types of air embolism could be differentiated; the single-bubble type and the 'stormy-bubble type'. The single-bubble type was observed during skin and muscle incisions, craniotomy, and brain lesion excision. Further embolism development was prevented by electrocoagulation and application of bone wax. The stormy-bubble type occurred during dura and muscle incisions and was prevented by electrocoagulation, reflection of the dura, or suturing the affected muscle. The routine use of a Swan-Ganz catheter for removal of air embolism by suction proved effective for the treatment of the stormy-bubble type of air embolism. Masking the operative field with saline-soaked cotton strips was of moderate benefit in the stabilization of the single-bubble type of air influx, but proved to be of little value in controlling the entrance of the stormy-bubble type.

Original languageEnglish
Pages (from-to)440-444
Number of pages5
JournalJournal of neurosurgery
Volume64
Issue number3
DOIs
Publication statusPublished - 1986 Jan 1

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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