Could cough be an intraoperative indicator for venous air embolism in deep brain stimulation surgeries?: experiences from a large case series. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Shi, Lin; Zhang, Chao-Cai; Li, Jun-Ju; Zhu, Guan-Yu; Chen, Ying-Chuan; Zhang, Jian-Guo
• Is Part Of: Chinese neurosurgical journal. Volume 2:Issue 1(2016)
• Page Start: 1
• Page End: 7
• Publication Date: 2016-12
• Subjects: Deep brain stimulation -- Venous air embolism -- Cough -- Clinical features; Nervous system -- Surgery -- Periodicals; Neurosciences -- Periodicals; 617.48005
• DOI: 10.1186/s41016-016-0048-1
• Languages: English
• ISSNs: 2057-4967

Abstract

Abstract Background Deep brain stimulation (DBS) surgery is usually performed with the patients located in a half-sitting position. Therefore, complications associated with such position accompany, such as venous air embolism (VAE), et al. However, because the patients are fully conscious during the surgery, they may have observable manifestations related to the complications that are otherwise inconspicuous in generally anesthetic surgeries. Thus, we designed this study to investigate the intraoperative manifestations of the potentially dangerous complication of VAE in the DBS surgery. Methods The medical records of a series of 705 consecutive patients who underwent DBS surgery in our hospital have been retrospectively reviewed. The clinical features, intraoperative manifestations and treatment of these patients were analyzed for evidence of VAE. The correlation between the cough intensity and other clinical features were investigated. Results Evidence of VAE were found in 16 patients. Statistical analyses showed that severe cough is associated with greater age (p = 0.045), longer coughing time (p = 0.001), more intensive tremor (p = 0.032), more complaints (p = 0.036), greater influences (p = 0.009), more treatment (p = 0.003) and longer hospitalization (p = 0.003). Conclusions Intraoperative intense and unremitting cough may be a noticeable indicator of possible VAE. Early recognition and effective management are essential to prevent unfavorable outcomes in such cases.