Doppler precordial monitoring is recommended as the most effective tool for detecting potentially severe venous air embolism during major head and neck surgeries.
Does not support changing monitoring practices yet; leaves open need for randomized validation in head and neck surgery.
Venous air embolism can occur under many circumstances, including head and neck surgery when the head is elevated. Embolized air obstructs the pulmonary outflow tract of the right ventricle or the pulmonary arterioles. Small volumes are tolerated or dispersed, but larger volumes can lead to severe physiologic changes. The Doppler precordial monitor is the most effective means of detection and should be used in major operations on the head and neck. Treatment methods are discussed and should be understood by all otolaryngologic surgeons.
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Roger L. Hybels (1980) studied this question.
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