[Transesophageal echocardiography and air embolism during posterior fossa neurosurgery. Intraoperative detection in the foramen ovale].
Sitting position during neurosurgery is discussed because the risk of venous air embolism and paradoxical air embolism is increased. Preoperative transoesophageal echocardiography is proposed to screen patients with patent foramen ovale to avoid them for the sitting position. This work reported 2 patients in conflict with this screening. It is discussed the physiological principles governing the paradoxical air embolism and the actual recommended monitoring for this position.
Lieutaud
T
T
Service d'anesthésie-réanimation, hôpital neurologique et neurochirurgical Pierre Wertheimer, BP Lyon-Montchat, 69394 Lyon, France. thomas.lieutaud@wanadoo.fr
Bodonian
C
C
Lak
C
C
Salord
F
F
Artru
F
F
D001254:Astrocytoma / Q000601:surgery; D001932:Brain Neoplasms / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D004618:Embolism, Air / Q000000981:diagnostic imaging*; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging*; D018325:Hemangioblastoma / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019635:Neurosurgical Procedures; D011187:Posture / Q000502:physiology*
Echocardiographie transoesophagienne et embolie gazeuse en neurochirurgie de la fosse cérébrale postérieure. Intérêts et limites du dépistage préopératoire du foramen ovale.