Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review.
We present a case report of successful resuscitation following cardiac arrest in a patient undergoing surgery in the prone position. A systematic review of the literature identified 22 further cases. Risk factors for intra-operative cardiac arrest in patients in the prone position include: cardiac abnormalities in patients undergoing major spinal surgery, hypovolaemia, air embolism, wound irrigation with hydrogen peroxide, poor positioning and occluded venous return. Cardiac arrest is also a risk in the increasing number of patients with acute respiratory distress syndrome ventilated in the prone position. Management of prone cardiac arrest may be improved by identification of high-risk patients, careful patient positioning, use of invasive monitoring and placement of self-adhesive defibrillator paddles. Suitable techniques for cardiopulmonary resuscitation including methods for chest compression, defibrillation and the management of air embolism are discussed.
Brown
J
J
Aneasthetics Department, Southmead Hospital, North Bristol NHS Trust, Bristol BS10 5NB, UK.
Rogers
J
J
Soar
J
J
D016063:Blood Loss, Surgical; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000628:therapy*; D008875:Middle Aged; D016684:Prone Position; D012307:Risk Factors; D013117:Spinal Cord Compression / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery