Sunday, October 3, 2021

Air embolism in surgeries

 Q: Why neurosurgical and ENT procedures are at higher risk for air embolism? 

 Answer: Because brain and head lies superior to the heart

The pressure gradient in body parts above the heart is higher than the central venous pressure (CVP) causing negative venous pressure relative to the atmosphere. Moreover, many times procedures in these areas are performed in the Fowler’s position. This allows air to easily sucked into the circulation while vessels are dissected and open to the atmosphere during the procedure.



1. Gale T, Leslie K. Anaesthesia for neurosurgery in the sitting position. J Clin Neurosci 2004; 11:693. 

2. Wong AY, Irwin MG. Large venous air embolism in the sitting position despite monitoring with transoesophageal echocardiography. Anaesthesia 2005; 60:811.

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