[Air embolism in neurosurgery. General data (author's transl)]

Area of Science:

• Neurosurgery
• Anesthesiology
• Vascular Surgery

Background:

• Air embolism is a recognized risk in neurosurgical procedures, particularly those performed in the sitting position.
• Factors influencing air embolism incidence include surgical site, ventilation methods, and detection criteria.

Observation:

• Venous air entry is the primary route, with potential passage into systemic circulation.
• Nitrous oxide administration can exacerbate air embolism size due to low blood solubility.
• Surgical tilt, intrathoracic/intracardiac pressures, and patient condition are critical determinants.

Findings:

• Air emboli can cause precapillary pulmonary hypertension and pulmonary edema.
• Cardiac effects include reduced venous return.
• Cerebral anoxia and edema can lead to neurological deficits and sequelae.

Implications:

• Understanding risk factors is crucial for preventing and managing neurosurgical air embolism.
• Early detection and intervention are vital to mitigate neurological and systemic complications.
• Further research into the mechanisms of gas passage through the lungs is warranted.