Real-time images were recorded from initial injection to 1.5 min. Microbubbles formed by agitating 10 mL saline with 1 mL of air across a stopcock 10 times were injected into the CVC over 2 s. TEE repositioning attained midesophageal right ventricular inflow outflow view, wherein RA, RV and PA are visualized. Following anesthetic induction and a transesophageal echo (TEE) probe placement, a Cook Bunegin-Albin Air Aspiration CVC was positioned in the SVC immediately adjacent to RA. Methods: An IRB-approved prospective study of 20 patients undergoing neurosurgical procedures in the seated position. This study examines injected microbubble clearance times from the right atrium (RA), right ventricle (RV) and pulmonary artery (PA) in the supine and seated position of patients undergoing neurosurgical procedures in the seated position. This assumption has yet to be tested in human subjects. This is predicated upon an assumption of bubble buoyancy, such that entrained air will localize to this superior-most intracardiac location in the seated patient. The rationale for the CVC is aspiration of entrained air from the right atrium with model studies suggesting this is the optimum location for retrieval of entrained air. First developed at this institution, CVC use has since become an internationally adopted practice for neurosurgical procedures in the seated position. A treatment for VAE is central venous catheter (CVC) placement with the CVC tip at the cavo-atrial junction.

Perkins: None.īackground: Venous air embolism (VAE) occurs in neurosurgical procedures performed in the seated position. Mayo Clinic, Rochester, Minnesota, United Statesĭisclosures: J.A. Effect of the Sitting versus the Supine Position on Microbubble Clearance Times from the Right Atrium, Right Ventricle and Pulmonary Artery

Supine position