title: Pulmonary oedema following venous air embolism during transsphenoidal pituitary surgery.
abstract: Venous air embolism (VAE) is a well known complication in procedures where the operative field is above the level of the heart. Acute pulmonary oedema after a large air embolus occurring during neurosurgery is also a recognized phenomenon. However, pulmonary oedema following repeated episodes of VAE in sublabial transsphenoidal (SLTS) surgery for pituitary adenoma has never been reported. We describe a case of VAE in a 65 year old male undergoing SLTS surgery for pituitary adenoma. Following this, the patient had pulmonary oedema which resolved on supportive treatment. Pulmonary oedema as a result of VAE may go unrecognised intraoperatively but can lead to a significant postoperative morbidity. Early suspicion and recognition of VAE and institution of aggressive treatment will help to avoid fatal consequences.
authors.affiliation: Neurosciences Centre, Department of Neuroanaesthesiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Arora
authors.forename: D
authors.initials: D
authors.lastname: Chablani
authors.forename: G P
authors.initials: GP
authors.lastname: Rath
authors.forename: H
authors.initials: H
authors.lastname: Prabhakar
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000368:Aged; D002550:Cerebral Veins; D003422:Critical Care; D004618:Embolism, Air / Q000150:complications* / Q000628:therapy; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy; D011654:Pulmonary Edema / Q000209:etiology* / Q000628:therapy; D012121:Respiration, Artificial; D012307:Risk Factors; D013101:Sphenoid Sinus / Q000601:surgery