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2014 | 68 | 5 | 302-306
Article title

Analysis of clinical implications of aeroembolism during cerebello-pontine angle tumor removal conducted in semi-sitting position

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PL
Analiza implikacji klinicznych zatoru powietrznego w trakcie operacji guzów kąta mostowo-móżdżkowego w pozycji półsiedzącej
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EN
Abstracts
EN
BACKGROUND The semi-sitting position of the patient during cerebellopontine angle (CPA) surgery enables the spontaneous outflow of blood and cerebrospinal fluid from the operation area. This restricts the necessity of using an aspirating nozzle and other instruments which are dangerous for local delicate structures like the facial nerve or labyrinthine artery. The disadvantage of the semi-sitting position is the risk of pneumatocele and aeroembolism. METHODS 214 patients operated on in the Department of Neurosurgery, Medical University of Silesia in Katowice were analyzed. Aeroembolism was correlated with such parameters as: perioperative death rate, duration of hospitalization in neurosurgical and intensive care wards, respiratory or circulatory insufficiency, necessity of using a respirator and the number of specialist consultations RESULTS Aeroembolism does not increase the death rate or duration of hospitalization in a neurosurgical ward, but it does expose patients to respiratory failure (p = 0.014). Aeroembolism is also correlated with hospitalization in an intensive care ward (p = 0.002) and increases the number of specialist consultations (p = 0.042). In our opinion, very important for the prevention of aeroembolism is surgeons’ care on the closure of every open vein , especially those in bone, using bone wax. The elevation of venous pressure due to manual compression on the cervical veins is the best method for locating not bleeding but open veins. CONCLUSIONS We have proved that a venous air embolism increases neither mortality nor the duration of hospitalization. We believe that prevention and early treatment of aeroembolism prevents further complications.
PL
W S T Ę P Pozycja półsiedząca pacjenta w trakcie operacji w obrębie kąta mostowo-móżdżkowego (KMM) umożliwia samoistny odpływ krwi i płynu mózgowo-rdzeniowego z pola operacyjnego. Ogranicza to konieczność używania w polu operacyjnym ssaka i innych narzędzi, którymi można uszkodzić tak delikatne struktury jak nerw twarzowy czy tętnica błędnikowa. Niedogodnością pozycji półsiedzącej jest ryzyko zatoru powietrznego i odmy mózgowej. METODY Analizie poddano 214 pacjentów operowanych w Katedrze i Klinice Neurochirurgii Śląskiego Uniwersytetu Medycznego w Katowicach. Wystąpienie zatoru powietrznego skorelowano z następującymi parametrami: zgon okołooperacyjny, okres hospitalizacji na oddziale neurochirurgicznym i oddziale intensywnej terapii, zaburzenia oddechowe i krążeniowe, konieczność pooperacyjnej respiratoroterapii, liczba konsultacji specjalistycznych. WYNIKI Zator powietrzny nie zwiększa śmiertelności okołooperacyjnej i czasu hospitalizacji na oddziale neurochiruricznym, ale naraża pacjentów na niewydolność oddechową (p = 0,014). Podwyższa też konieczność hospitalizacji na oddziale intensywnej terapii (p = 0,002) i częstość konsultacji specjalistycznych (p = 0,042). WNIOSKI Potwierdziliśmy, że zator powietrzny nie wpływa na śmiertelność okołooperacyjną i czas hospitalizacji. Zapobieganie zatorowi i jego wczesne leczenie pozwala uniknąć dalszych komplikacji.
Discipline
Publisher

Year
Volume
68
Issue
5
Pages
302-306
Physical description
Contributors
  • Department of Physiotherapy Academy of Business, Dąbrowa Górnicza
  • Department of Neurosurgery Medical University of Silesia in Katowice
author
  • Department of Anaesthesiology and Intensive Care Medical University of Silesia, Katowice
author
  • Department of Physiotherapy Academy of Business, Dąbrowa Górnicza
author
  • Department of Neurosurgery Medical University of Silesia in Katowice
author
  • Department of NeurosurgeryMedical University of Silesia in Katowice
  • Department of Neurosurgery Medical University of Silesia in Katowice
References
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Document Type
article
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YADDA identifier
bwmeta1.element.psjd-ab28f9da-160c-4e68-bc78-f9e3727a5afa
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