Abstract
Cardiac arrest in unusual positions represents an additional challenge for anesthesiologists. This paper reports a successful cardiopulmonary resuscitation during neurosurgical procedure in which high-quality chest compressions was performed in the prone position. The aim of this report is disclose the knowledge of resuscitation maneuvers in a position other than supine. A 77-year-old female patient presented for excision of parietal-occipital meningioma in the prone position with the head fixed on a Mayfield head-holder. During the surgical procedure the sagittal sinus was disrupted. The patient presented an abrupt hemorrhagic shock leading to a cardiac arrest by hypovolemia despite vigorous volume replacement. Cardiac massage was promptly initiated in the prone position. After two minutes, there was a return of spontaneous circulation. The patient was discharged without sequelae. We concluded that high-quality chest compressions in the prone position were able to generate sufficient cardiac output.
Highlights
Cardiac arrest is the outcome most feared by both anesthesiologists and surgeons, especially within the context of an elective procedure
This paper reports a successful cardiopulmonary resuscitation during neurosurgical procedure in which high-quality chest compressions was performed in the prone position
OJAnes studies suggest that cardiopulmonary resuscitation (CPR) in the prone position is most advantageous, generating higher blood pressures when compared to supine position [2,3,4]
Summary
Cardiac arrest is the outcome most feared by both anesthesiologists and surgeons, especially within the context of an elective procedure. Cardiac arrest in unusual positions, such as the prone position, represents an additional challenge primarily because the knowledge about the technique is not so release and the effectiveness of external chest compressions over the back has not recognizes widely. The current methods used are adapted from the technique of cardiopulmonary resuscitation (CPR) in the supine position. The learning about this issue is mainly based on case reports and there are no specific guidelines on how to proceed in these circumstances
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