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Cardiac arrest and resuscitation of a 6‐month old achondroplastic baby undergoing neurosurgery in the prone position
Author(s) -
Kelleher A.,
Mackersie A.
Publication year - 1995
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1995.tb04615.x
Subject(s) - medicine , prone position , bradycardia , anesthesia , foramen magnum , air embolism , resuscitation , decompression , cardiopulmonary resuscitation , surgery , blood pressure , complication , heart rate
Summary We describe the case of a 6‐month‐old achondroplastic baby who underwent foramen magnum decompression to relieve congenital cervical cord compression. During the procedure, acute hypotension occurred secondary to cord compression, and following attempts to alleviate this, torrential haemorrhage ensued and air was entrained into the circulation through large venous channels in the surgical field. This resulted in an asystolic cardiac arrest from which the baby was resuscitated whilst remaining in the prone position. Haemorrhage remained difficult to control and a second episode of air embolism occurred 5min later leading to a profound bradycardia and hypotension again requiring full cardiorespiratory resuscitation in the prone position. In total, 11 min elapsed before an adequate spontaneous cardiac output was re‐established. The procedure was abandoned and the patient transferred to the intensive care unit for postoperative management. An electroencephalogram performed after 24 h was reported as normal, and clinically the child made a full neurological recovery.