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BACKGROUND: The authors report a case of venous air embolism (VAE) during a pediatric posterior fossa craniotomy with resulting pulmonary edema requiring postoperative ventilation. Pulmonary edema is a known but rare complication of VAE, and diagnosis and treatment are discussed. OBSERVATIONS: The embolism was undetected during the surgical procedure, and the first clinical sign of respiratory decompensation appeared an hour after the initial insult, with imaging suggesting acute pulmonary edema. A transient but significant end-tidal carbon dioxide decrease was detected on postoperative review of the anesthesiology record. LESSONS: This report highlights an uncommon sequela of VAE and the importance of post hoc automated record review for intraoperative event analysis.
Wood et al. (Mon,) studied this question.