title: An abrupt reduction in end-tidal carbon-dioxide during neurosurgery is not always due to venous air embolism: a capnograph artefact.
abstract: Venous air embolism (VAE) is a well recognized complication during neurosurgery. Pre-cordial doppler and trans-esophageal echocardiography are sensitive monitors for the detection of VAE. A sudden, abrupt reduction in the end-tidal carbondioxide (ETCO2) pressure with associated hypotension during neurosurgery might suggest VAE, when more sensitive monitors are not available. We describe an unusual cause for sudden reduction in ETCO2 during neurosurgery and discuss the mechanism for such presentation.
authors.affiliation: Department of Neuroanaesthesia, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560 029, India.
authors.forename: Byrappa
authors.initials: B
authors.lastname: Vinay
authors.forename: Kamath
authors.initials: K
authors.lastname: Sriganesh
authors.forename: Kadarapura Nanjundaiah
authors.initials: KN
authors.lastname: Gopala Krishna
mesh_terms: D000328:Adult; D016477:Artifacts; D001944:Breath Tests / Q000379:methods*; D019296:Capnography / Q000379:methods*; D002245:Carbon Dioxide / Q000032:analysis*; D003937:Diagnosis, Differential; D004618:Embolism, Air / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D013990:Tidal Volume; D014689:Venous Insufficiency / Q000175:diagnosis / Q000209:etiology
chemical_list: D002245:Carbon Dioxide