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Cerebral air embolism in pediatric patients undergoing cardiac surgery
Evyatar Hubara1,2, Iris Motro Feingold3, Yelena Skourikhin4
1Pediatric Intensive Care Unit, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel. Evyatar.hubara@sheba.health.gov.il.
Insights
Pediatric cardiac surgery patients can experience cerebral air embolism, a serious complication. This case series details six children, highlighting varied neurological outcomes and proposing management guidelines for this rare event.
Area of Science:
- Pediatric Cardiology
- Neurosurgery
- Cardiovascular Surgery
Background:
- Cerebral air embolism is a severe complication during cardiopulmonary bypass (CPB).
- It poses significant neurological risks, particularly in pediatric patients undergoing cardiac surgery.
Purpose of the Study:
- To present a case series of pediatric patients experiencing cerebral air embolism during CPB.
- To detail the presentation, management, and outcomes of these cases.
- To propose management guidelines for suspected cerebral air emboli in this population.
Main Methods:
- A case series report was conducted.
- A retrospective review of medical records identified pediatric patients with cerebral air embolism during cardiac surgery with CPB (January 2009 - December 2023).
Main Results:
- Six pediatric patients (8 months to 16 years) experienced cerebral air embolism during cardiac surgery.
- Five cases involved tear-induced emboli from right atrium dissection, often in patients with single ventricle physiology.
- Seizures were the predominant manifestation, with neurological outcomes ranging from minimal deficits to substantial damage.
Conclusions:
- This case series documents the occurrence of cerebral air embolism during pediatric cardiac surgery.
- The study highlights a spectrum of neurological outcomes in affected children.
- Guidelines are provided for the identification and treatment of this rare complication.
Objective:
Cerebral air embolism during Cardio-Pulmonary Bypass is a severe complication with significant neurological risks. We present six pediatric cases, detailing their presentation, management, and outcomes. The discussion reviews existing literature and proposes management guidelines for suspected air emboli.
Methods:
A Case Series Report. A retrospective review of medical records was conducted to identify pediatric patients who experienced cerebral air embolism during cardiac surgeries with CPB between January 2009 to December 2023.
Main Findings:
Throughout the study duration, six patients experienced cerebral air emboli as a complication of their cardiac surgeries. Patients' ages ranged from 8 months to 16 years, with five having single ventricle physiology. Tear-induced cerebral air emboli from right atrium dissection were observed in five cases. Seizures following surgery were the predominant clinical manifestation. Neurological outcomes varied; three patients showed minimal deficits at discharge, while other three cases suffered significant damage leading to substantial deficits.
Conclusions:
We present a case series documenting the occurrence of a rare complication-cerebral air emboli-during cardiac surgery in children. Our study highlight a spectrum of neurological outcomes in affected patients and provides guidelines for the identification and treatment of this complication.
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