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Canadian Journal of Anesthesia, Vol 31, 86-90, Copyright © 1984 by Canadian Anesthesiologists' Society

Venous Air Embolism in a Child Undergoing Posterior Fossa Craniotomy: A Case Report

SUSAN S. PORTER MD1, ROBERT C. BOYD MD1, and MAURICE S. ALBIN MD, MSC (ANES.)1

1 Department of Anesthesiology, University of Texas Health Science Center, San Antonio, Texas

Address correspondence to: Susan S. Porter MD, Department of Anesthesiology, University of Kansas Medical Center, 39th and Rainbow Boulevard, Kansas City, Kansas 66103.

The incidence of venous air embolism in children undergoing neurosurgical procedures in the sitting position may be as high as 33 per cent. It may be more serious in children because smaller total volumes of air can produce serious physiologic disturbances or fatalities, and the risk of systemic air embolism through a patent foramen ovale or patent ductus arteriosus may be greater than in adults. The case of a six-year-old child who sustained four separate episodes of air embolism while undergoing posterior fossa exploration is presented. Early episodes were well tolerated, but later episodes produced clinical instability. A total of 11 cc of air was recovered from an indwelling right atrial catheter, and the patient recovered uneventfully. This case report illustrates the physiologic changes produced by venous air embolism and reviews the importance of adequate monitoring techniques and early treatment.

Key Words: COMPLICATIONS: air embolism • EMBOLISM: AIR • ANAESTHESIA: paediatric






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Copyright © 1984 by the Canadian Anesthesiologists' Society.