Wong A Y C, Irwin M G
Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong ROC.
Anaesthesia. 2005 Aug;60(8):811-3. doi: 10.1111/j.1365-2044.2005.04237.x.
A 49-year-old male with neurofibromatosis type II was scheduled for posterior fossa craniotomy and excision of a right acoustic neuroma and placement of an auditory brainstem implant in the sitting position. Intra-operatively, the patient was monitored with transoesophageal echocardiography which detected two major episodes of venous air embolism. Despite immediate treatment the patient's gas exchange progressively worsened during surgery and a chest X-ray showed extensive bilateral pulmonary infiltrates. The patient developed acute respiratory distress syndrome and required inotropic support in the intensive care unit. Although transoesophageal echocardiography allowed rapid detection of venous air embolism, there was no evidence of therapeutic benefit.
一名49岁的患有Ⅱ型神经纤维瘤病的男性计划接受后颅窝开颅手术，切除右侧听神经瘤，并在坐位下植入听觉脑干植入物。术中，通过经食管超声心动图对患者进行监测，检测到两次主要的静脉空气栓塞事件。尽管立即进行了治疗，但患者在手术过程中的气体交换仍逐渐恶化，胸部X线显示双侧肺部广泛浸润。患者发展为急性呼吸窘迫综合征，在重症监护病房需要使用血管活性药物支持。尽管经食管超声心动图能够快速检测到静脉空气栓塞，但没有证据表明其具有治疗益处。
