The impact of transesophageal echocardiography based protocol for management of adults in the sitting position on the incidence of clinically significant venous air embolism
| Autor: | Aleksey V. Shchyogolev, Dmitry Vladimirovich Svistov, Aleksey I. Gayvoronsky, D. A. Averyanov, Roman S. Lakotko |
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| Rok vydání: | 2020 |
| Předmět: |
head elevated position
Medicine (General) medicine.medical_specialty transesophageal echocardiography business.industry patent foramen ovale Incidence (epidemiology) General Medicine Venous air embolism Sitting medicine.disease sitting position venous air embolism 03 medical and health sciences Position (obstetrics) R5-920 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine Cardiology medicine Patent foramen ovale business 030217 neurology & neurosurgery |
| Zdroj: | Russian Open Medical Journal, Vol 9, Iss 1, p e0107 (2020) |
| ISSN: | 2304-3415 |
| Popis: | The purpose of the study was to evaluate the impact of transesophageal echocardiography (TEE) – based protocol for management of adults in the sitting position during elective neurosurgical interventions on the incidence of clinically significant venous air embolism (VAE). Material and Methods ― The study involved 155 adult neurosurgery patients (70 in prospective group and 85 in retrospective group). Surgery in both groups was done in the sitting position. In the prospective group TEE-based protocol was used. Retrospective group served as control. The primary endpoint was considered to be a decrease in the frequency of clinically significant VAE in the prospective group in comparison with the retrospective one. In the prospective group, VAE with Tuebingen grade 3-5 was considered clinically significant. The PFO incidence and severity and the effect of the number of episodes of VAE per case on its maximum severity during surgery were also analyzed. Any complication in the postoperative period believed to be associated with the position of the patient on the table during the surgery was recorded. Results ― The incidence of the clinically significant VAE in the retrospective group was 23.5% (95% CI 15-34) and was 16.4% higher than the frequency in the prospective group (chi-square=7.6197, df=1, p=0.005). 50% (95% CI 38-62) of patients in prospective group developed VAE during surgery. In 16 cases, the number of episodes was more than one. The number of episodes of VAE in the observation was reliably associated with the maximum severity of VAE during the observation (Z=4.11; p |
| Databáze: | OpenAIRE |
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