Venous air embolism and the sitting position: A case series

Venous air embolism is a potentially serious complication of neurosurgery that occurs more commonly when the patient is in the sitting position. In this study, we aimed to quantify the incidence of venous air embolism during neurosurgical procedures performed with the patient in the sitting position in our institution. We performed a prospective audit of venous air embolism in 100 consecutive patients who underwent neurosurgical procedures in the sitting position, as evidenced by a decrease in end-tidal carbon dioxide partial pressure of 5 mmHg or more within 5 min. The incidence of venous air embolism was 9% (95% confidence interval: 3.3–14.7%). These patients did not have a significantly higher rate of hypotension or desaturation. Our results suggest that the sitting position can be safely used in neurosurgery.