Abstract
Venous air embolism (VAE) is the air bubble accumulation in the right side of the heart, or in the pulmonary region. Pre-cordial Doppler allows a real-time monitoring of heart sound and is used to detect VAE episodes through changes in cardiac sound. Sometimes these changes are not detected by the operator, which reveals the importance of finding other robust methods for VAE detection. This work aims to study entropy as a feature of the heart sound that may provide useful information on VAE episodes.A clinical protocol was designed: Doppler Heart Sound (DHS) was collected at baseline, and following infusions of saline with 4 distinct volumes and 2 infusion rates, and given through 2 infusion vias, to 4 patients enrolled in the clinical study. Entropy of these segments was obtained, and relation between the extracted feature and saline infusions was studied.Entropy presents a good performance showing an increase in response to saline injections (increased blood flow turbulence).
Highlights
Venous Air Embolism (VAE) is a serious complication that may occur during neurosurgical procedures (Law et al, 2012)
This work aims to continue the previous study in (Tedim et al, 2014), where some features were extracted from the Doppler heart sound before and after infusions of saline at different rates and volumes of entry, with results indicating that the entropy was the feature with best results in blood flow turbulence detection (75% of saline injections were detected)
Patients enrolled in this study were submitted to total intravenous anesthesia (TIVA), a widely used anesthetic technique, where general anesthesia is given by an intravenous line (Eikaas and Raeder, 2009)
Summary
Venous Air Embolism (VAE) is a serious complication that may occur during neurosurgical procedures (Law et al, 2012) It is the result of the existence of pressure gradients between the right side of the heart and the incisional area (Albin, 2011). Both volume and rate of air accumulation are dependent on the size of the vascular lumen as well as the pressure gradient. These factors determine the morbidity and mortality of any episode of VAE, as well as the position of the patient (Palmon et al, 1997; Mirski et al, 2007). The highest rate of VAE occurrence in neurosurgeries is for the seated posterior fossa surgery
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