Saigal Deepti, Ganjoo Pragati, Tetarway Madhumita, Kiro Kiranlata
Department of Anaesthesiology and Intensive Care, GB Pant Hospital, Maulana Azad Medical College, New Delhi, India.
Asian J Neurosurg. 2017 Apr-Jun;12(2):214-216. doi: 10.4103/1793-5482.150223.
Venous air embolism (VAE) is a well-known complication of sitting position neurosurgery which most characteristically manifests as mild to severe hemodynamic alterations. Development of pulmonary edema is a known, though infrequent, manifestation of VAE. We report here the occurrence of acute pulmonary edema without accompanying hemodynamic changes in a patient undergoing retromastoid craniotomy and tumor decompression in the sitting position. The patient required supportive treatment and elective ventilation for 11 days before the edema resolved. He also developed significant postoperative thrombocytopenia which though, was self-limiting. Thus, VAE may manifest with atypical manifestations like pulmonary edema and thrombocytopenia that can significantly contribute to postoperative patient morbidity.
静脉空气栓塞（VAE）是坐位神经外科手术中一种众所周知的并发症，其最典型的表现为轻度至重度血流动力学改变。肺水肿的发生是VAE的一种已知但不常见的表现。我们在此报告一例在坐位下行乳突后开颅术和肿瘤减压术的患者发生急性肺水肿且无伴随血流动力学变化的情况。该患者在水肿消退前需要支持治疗和选择性通气11天。他还出现了明显的术后血小板减少症，不过这是自限性的。因此，VAE可能表现为肺水肿和血小板减少症等非典型表现，这些表现可显著增加术后患者的发病率。
