Intensive care after elective craniotomy: 'all politics is local'

摘要

In cases of patients with a right-left shunt, the sitting or semi-sitting position is considered a contraindication, and patients with PFO should be screened before the surgery under semisitting or sitting position to reduce potential risks of arterial air embolism. Feigl et al. detected patients with PFO preoperatively in 52 of 200 consecutive patients who planned to undergo surgery in the semisitting position, and performed surgery in the semisitting position after informing the patients of the increased risk of VAE during surgery and possible clinical consequences, the advantages of the position, and clinical outcomes in their institute. Their prospective study between January 2008 and December 2009 showed the actual low clinically relevant risk for patients with PFO during surgery in the semisitting position, and also showed the high occurrence of venous air bubbles visible in the TEE in their experienced teams.