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Venous air embolism during semi‐sitting craniotomy evokes thrombocytopenia
Author(s) -
Schäfer S. T.,
Sandalcioglu I. E.,
Stegen B.,
Neumann A.,
Asgari S.,
Peters J.
Publication year - 2011
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.1365-2044.2010.06584.x
Subject(s) - medicine , craniotomy , sitting , platelet , anesthesia , embolism , pulmonary embolism , venous thrombosis , air embolism , venous blood , surgery , cardiology , thrombosis , complication , pathology
Summary Venous air embolism activates platelets in vitro and can evoke platelet dysfunction in swine. We tested the hypothesis that venous air embolism during semi‐sitting craniotomy induces thrombocytopenia in humans. We analysed the charts of 799 patients who had an elective craniotomy in the semi‐sitting position between 1990 and June 2009. Venous air embolism occurred in 52 patients (6.5%) and was associated with a decrease in mean (SD) in platelet count from 270 (75) × 10 9 l −1 to 194 (62) × 10 9 l −1 (p < 0.001). In age‐matched controls without venous air embolism mean (SD) platelet count did not change (254 (82) × 10 9 l −1 vs. 250 (97) × 10 9 l −1 (NS). While mean (SD) haematocrit fell slightly in both groups (venous air embolism: 0.40 (0.05) to 0.32 (0.04), p < 0.001; no venous air embolism: 0.41 (0.04) to 0.35 (0.05), p < 0.001), normalising platelet count to haematocrit did not alter the results.