Detection and elimination of potentially pathologic air embolization in cardiac surgery with the use of multi-modal neuromonitoring: a case report

Abstract

Neurological injuries can occur at the time of cardiac surgery. The results of such complications can be life-altering and altogether fatal. Most commonly, Near-infrared spectroscopy (NIRS), which measures brain oxygenation, is the only neuromonitoring that is performed at the time of cardiac surgery. This is despite publications that multi-modal intra-operative neuromonitoring provides a range of information to the cardiac surgery team, that not only detects an insult, but can provide detailed information to allow intervention that will mitigate the devastating result of such insult. We present this case report to demonstrate how multi-modal neuromonitoring allowed us to detect and eliminate a potentially devastating air embolization. We advocate for the use of multi-modal neuromonitoring in every cardiac case.