How is venous air embolism (VAE) prevented during neurosurgical interventions?

Updated: Dec 30, 2017
  • Author: Brenda L Natal, MD, MPH; Chief Editor: Erik D Schraga, MD  more...
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Answer

The optimal management of VAE is prevention. Minimizing the pressure gradient between the site of potential entry and the right atrium is essential in prevention of VAE.

Potential measures to reduce the risk and/or severity of VAE during neurosurgical interventions include the following [38] :

  • Using a modified semisitting or lounging position for the patient, in which the head is lower than the legs to create a positive pressure in the transverse and sigmoid sinuses
  • Avoiding hyperventilation in the sitting position
  • Using a sitting position, under strict protocol, for procedures in patients with known patent foramen ovale

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