The sitting position in neurosurgery: indications, complications and results. a single institution experience of 600 cases

Abstract

In our series, VAE was detected in 19 % of all patients in the sitting position. However, in only 0.5 % of cases a termination of the surgical procedure became necessary. In all other cases, the cause of air embolism could be found and eliminated during surgery. TEE was found to be the monitoring technique with the highest sensitivity. In our opinion, the sitting position is a safe positioning technique if TEE monitoring is used.

Paradoxical air embolism resulted in acute myocardial infarction and massive ischemic brain injury in a patient operated on in a sitting position

“…Венозная воздушная эмболия является доста-точно распространенным осложнением нейрохи-рургических вмешательств, выполняемых в поло-жении сидя [2,4,[9][10][11][12]. По данным разных авторов [1-3, 5, 11, 13], частота данного осложнения коле-блется в диапазоне 1,6-76%, в зависимости от того, какие эпизоды ВВЭ фиксируют авторы (все или только массивные), и использованного метода диа-гностики ВВЭ, которые обладают различной чув-ствительностью.…”

Intraoperative Transesophageal Echocardiography: Review and Evolution

“…While TEE is the most sensitive modality for detecting air in the right atrium, sitting position is relatively safe without TEE and TEE does not change outcomes. Additionally TEE is cumbersome given where the patient and surgeon are positioned [1,52].…”

Carbon dioxide field flooding reduces the hemodynamic effects of venous air embolism occurring in the sitting position

“…Two of its main advantages are an optimal biomechanical condition of intracranial compartments of the patients and an ideal ergonomic position for the surgeons. However, despite several studies confirming its relative safety, the sitting position is burdened by significant complications that, according to some authors, even balance the aforementioned advantages [1][2][3][4][5][6][7][8][9][10][11][12][13].…”