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坐位开颅术后意外发生肺水肿:一种静脉空气栓塞并发症。

Unexpected pulmonary edema following sitting position craniotomy: A venous air embolism complication.

作者信息

Daqour Ahmed, Fraij Abdalkareem, Khawaja Dina, Hussain Tassnim, Mabhouh Tawfiq, Salahaldin Mohammad, Saifi Motaz, Abuawad Mohammad

机构信息

Department of neurosurgery Almakassed Hospital Jerusalem Palestine.

Department of Medicine Al-Quds University Jerusalem Palestine.

出版信息

Respirol Case Rep. 2024 Dec 12;12(12):e70093. doi: 10.1002/rcr2.70093. eCollection 2024 Dec.

DOI:10.1002/rcr2.70093
PMID:39669669
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11637535/
Abstract

We report a case of a 42-year-old female who had non-cardiogenic pulmonary edema following a setting position craniotomy to remove a left cerebellar pontine angle mass. During the operation, the patient experienced a sudden drop in her end-tidal CO2 levels, which needed an immediate intervention. After ruling out other potential causes, we determined that air venous embolism was the cause of this unexpected and serious complication. However, the condition was self-limited and resolved with supportive treatment after approximately 1 week. This case highlights the importance of recognizing and managing the unexpected complications of venous air embolism, as well as how prompt intervention and supportive treatment are critical for improving patient outcomes.

摘要

我们报告了一例42岁女性患者,该患者在采取仰卧位开颅手术切除左侧小脑桥脑角肿物后出现了非心源性肺水肿。手术过程中,患者的呼气末二氧化碳水平突然下降,需要立即进行干预。在排除其他潜在原因后,我们确定空气静脉栓塞是这一意外且严重并发症的病因。然而,该病情具有自限性,经过约1周的支持治疗后得以缓解。本病例凸显了识别和处理静脉空气栓塞意外并发症的重要性,以及及时干预和支持治疗对于改善患者预后的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad1/11637535/b2c804342da9/RCR2-12-e70093-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad1/11637535/9c61b0db9d7d/RCR2-12-e70093-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad1/11637535/c6029d45da05/RCR2-12-e70093-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad1/11637535/b2c804342da9/RCR2-12-e70093-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad1/11637535/9c61b0db9d7d/RCR2-12-e70093-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad1/11637535/c6029d45da05/RCR2-12-e70093-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ad1/11637535/b2c804342da9/RCR2-12-e70093-g004.jpg

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Unexpected pulmonary edema following sitting position craniotomy: A venous air embolism complication.坐位开颅术后意外发生肺水肿:一种静脉空气栓塞并发症。
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本文引用的文献

1
Acute pulmonary edema and thrombocytopenia following venous air embolism during sitting position neurosurgery.坐位神经外科手术期间静脉空气栓塞后出现急性肺水肿和血小板减少症。
Asian J Neurosurg. 2017 Apr-Jun;12(2):214-216. doi: 10.4103/1793-5482.150223.
2
The sitting position for neurosurgery: yet another case series confirming safety.神经外科手术的坐姿:又一个证实安全性的病例系列
World Neurosurg. 2012 Jan;77(1):42-3. doi: 10.1016/j.wneu.2010.12.009.
3
Diagnosis and treatment of vascular air embolism.血管空气栓塞的诊断与治疗。
Anesthesiology. 2007 Jan;106(1):164-77. doi: 10.1097/00000542-200701000-00026.
4
The sitting position in neurosurgery: a critical appraisal.神经外科手术中的坐姿:批判性评估。
Br J Anaesth. 1999 Jan;82(1):117-28. doi: 10.1093/bja/82.1.117.