Detection of gas embolism in neurosurgery by capnography. Apropos of 32 patients surgically treated in seated position
Simo Moyo, J.; Adnet, P.; Wambo, M.
Cahiers d'Anesthesiologie 43(1): 77-79
1995
ISSN/ISBN: 0007-9685 PMID: 7671062 Document Number: 441271
Hitherto dreaded and dreadful, air embolism has since the past few years a better prognosis owing to new techniques of early detection. The present study concerns a series of 32 neurosurgical patients who were operated in the sitting position under continuous capnography. This method not only provides global monitoring (metabolic, haemodynamic and respiratory) but also allows early detection of any significant migration of air or gas into the blood vessels. The incidence of air embolism in this series was 31% (10 patients out of 32). The onset of air embolism was diagnosed on a rapidly progressive fall in the expired fraction of CO2 (FECO2), in spite of a normal blood pressure. Early treatment prevented further complications. Therefore capnography is a sensitive and reliable method of air embolism detection intraoperatively. Its use in the operating room and intensive care unit should be systematic whenever air embolism may occur.