Intraoperative Venous Air Embolism in Semi-Sitting Position

Venous air embolism is a complication with high mortality and morbidity which may occur in neurosurgical operations especially in patients with semi-sitting, sitting and even supine position.In a patient who underwent surgery because of a glial tumour located in the parietal lobe end tidal CO2, O2 saturation and systemic blood pressure decreased suddenly during the operation. The aeration of the left lung was restricted and a pansystolic cardiac murmur was auscultated. Air was aspirated from the central catheter of the patient who was thought to have developed venous air embolism and hemodynamic stability was reassured. At the end of the operation the patient was awaken and extubated. In this case the potential complications were prevented by standard optimum monitoring and early intervention. The aim of this case report is to remind the close follow up of the patients undergoing neurosurgical operations in semi-sitting, sitting or supine positions by central venous catheterization and arterial monitoring additionally to the standard monitoring, carries importance in early diagnose and therapy of possible complications.