Wood Samuel, Fuzaylov Gennadiy
Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
J Neurosurg Case Lessons. 2021 Jan 18;1(3):CASE2075. doi: 10.3171/CASE2075.
The authors report a case of venous air embolism (VAE) during a pediatric posterior fossa craniotomy with resulting pulmonary edema requiring postoperative ventilation. Pulmonary edema is a known but rare complication of VAE, and diagnosis and treatment are discussed.
The embolism was undetected during the surgical procedure, and the first clinical sign of respiratory decompensation appeared an hour after the initial insult, with imaging suggesting acute pulmonary edema. A transient but significant end-tidal carbon dioxide decrease was detected on postoperative review of the anesthesiology record.
This report highlights an uncommon sequela of VAE and the importance of post hoc automated record review for intraoperative event analysis.
作者报告了1例小儿后颅窝开颅手术期间发生静脉空气栓塞（VAE）的病例，术后出现肺水肿，需要机械通气。肺水肿是VAE一种已知但罕见的并发症，本文对其诊断和治疗进行了讨论。
手术过程中未检测到空气栓塞，最初损伤1小时后出现呼吸代偿失调的首个临床体征，影像学检查提示急性肺水肿。术后复查麻醉记录发现呼气末二氧化碳短暂但显著下降。
本报告强调了VAE一种不常见的后遗症，以及事后自动记录复查对术中事件分析的重要性。
