Rapid recognition and treatment of cerebral air embolism: the role of neuromonitoring

Yeh, Thomas; Austin, Erle H.; Sehic, Aida; Edmonds, Harvey L.

doi:10.1016/s0022-5223(03)00199-5

Cited by 29 publications

(10 citation statements)

References 3 publications

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“…[5] In the present patient, the initiation of femoro-femoral CPB took about 5 min and considerable time elapsed by the time innominate vein was cannulated after completion of sternotomy. As we could not detect further air entrainment once the surgical site was packed, the role of retrograde cerebral perfusion was considered to be of limited value and was omitted.…”

Section: Discussionmentioning

confidence: 70%

"Air embolism during fontan operation"

2014

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In patients with a right to left intracardiac shunt, air embolism results in an obligatory systemic embolization. Nonembolization of entrained air is described in a child with a single ventricle physiology who had earlier undergone bidirectional Glenn shunt construction and Damus-Kaye-Stansel anastomosis. The air entrainment was detected by intra-operative transesophageal echocardiography. The combined effect of a "diving bell" phenomenon and mild aortic valve regurgitation are suggested as the reasons for the confinement of air into the ventricle preventing catastrophic systemic embolization.

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Section: Discussionmentioning

confidence: 70%

"Air embolism during fontan operation"

2014

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“…Yeh and colleagues 33 described the diagnostic advantage provided by multimodality neuromonitoring in a case of unsuspected cerebral air embolism. During a congenital heart operation managed with fibrillatory arrest, occult air embolism was detected by TCD, followed shortly by a precipitous decline in cerebral oximetry and the appearance of EEG changes.…”

Section: Multimodality Neuromonitoringmentioning

confidence: 99%

Multimodality Neuromonitoring for Pediatric Cardiac Surgery

Clark

Barnes

Ündar

et al. 2012

World J Pediatr Congenit Heart Surg

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Brain injury remains a source of morbidity associated with congenital heart surgery. Intraoperative neuromonitoring is used by many centers to help minimize neurologic injury and improve outcomes. Neuromonitoring at our institution is performed using a combination of near-infrared spectroscopy, transcranial Doppler ultrasound, electroencephalography, and somatosensory evoked potentials. Adverse or concerning parameters instigate attempts at corrective intervention. A review of the literature regarding neuromonitoring studies in pediatric cardiac surgery shows that evidence is limited to demonstrate that intraoperative neuromonitoring is associated with improved neurologic outcomes. Further clinical research is needed to assess the utility and cost-effectiveness of intraoperative neuromonitoring for pediatric heart surgery.

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“…16, Suppl. 3 54 challenging due to difficulty in interpretation from electrical signal interference and anaesthetic effects.…”

Section: Electroencephalographymentioning

confidence: 99%

“…The following day, restoration of symmetric high-frequency electrical activity has occurred. Data from Yeh et al 54…”

Section: Multimodality Monitoringmentioning

confidence: 99%

Monitoring the brain before, during, and after cardiac surgery to improve long-term neurodevelopmental outcomes

et al. 2006

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Innovation in surgical and medical management of cardiac disease has generated a dramatic improvement in operative survival. Along with these favourable results in terms of survival is the heightened awareness of neurologic complications, which often become evident beyond the early postoperative period. A large, multicentre prospective study found serious neurologic injury occurs in about one-twentieth of patients after myocardial revascularization in adults.1 More subtle evidence of persistent cognitive decline and functional impairment has been shown to occur in over two-fifths of such patients.2 Acute neurologic abnormalities are reported in up to one-fifth of infants and children who undergo cardiac surgery.3–6 Lasting impairments in cognitive, motor, and expressive functioning have been reported in up to three-fifths of children who have undergone complex cardiac surgery during infancy.7 Specifically, gross and fine motor delays, visual-spatial problems, language deficits and long-term emotional and behavioural problems have been found.8–13

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Rapid recognition and treatment of cerebral air embolism: the role of neuromonitoring

Cited by 29 publications

References 3 publications

"Air embolism during fontan operation"

"Air embolism during fontan operation"

Multimodality Neuromonitoring for Pediatric Cardiac Surgery

Monitoring the brain before, during, and after cardiac surgery to improve long-term neurodevelopmental outcomes

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