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Uptodate Reference Title
Monitoring for venous air embolism during neurosurgery
Monitoring for venous air embolism during neurosurgery
Surgical procedure
Precordial Doppler
Transesophageal echocardiography
Central venous catheter*
Craniotomy with high anatomic risk of VAE¶
X
X
X
Procedures performed in the sitting position
Craniotomy with general anesthesia
X
X
X
Craniotomy awake
X
Cervical spine surgery
X
X
Torticollis denervation surgery
X
X
Deep brain stimulator placement
X
This table shows typical monitoring for neurosurgical procedures with a high risk of intraoperative VAE, in addition to standard intraoperative physiologic monitors. The choice of monitors, including placement of an intra-arterial catheter, should be individualized based on patient and surgical factors.
VAE: venous air embolism. * A central venous catheter is placed to allow aspiration of air should VAE occur. ¶ High anatomic risk is determined in consultation with the surgeon, and may be the result of surgery near major intracranial venous sinuses or other vascular structures, or surgery that would make control of a vascular injury difficult.