Impacto de intervenciones para el manejo del embolismo aéreo cerebral masivo en cirugía de bypass cardiopulmonar

Abstract

Background: Massive cerebral air embolism during cardiopulmonary bypass (CPB) is catastrophic and in some instances, has the potential to lead to fatal outcomes. Its incidence is around 0.1% to 0.2% % (1) and secuelae of it can be devastating and in some instances fatal (2,3). There is not an evidence-based algorithm for the diagnosis and intraoperative management of this complication (4). Methodology: Qualitative systematic review and meta-analysis. PRISMA-P guidelines will be followed for the elaboration, redaction, and publication of the protocol (5). Results: Two thousand and sixty six articles were identified. Of these, 135 possible articles were considered for analysis of title and abstract. Thirty-three articles were retrieved for full text review. Of these, two articles were excluded since they did not met inclusion criteria. Two articles were included for meta-analysis and 29 case reports and series were included for description. Conclusion: The best management strategy for a complication of this type is prevention. Nevertheless, a surgical team may ultimately be confronted with such an occurrence at some point despite all the prevention strategies, as was the case with our patient. That is why, in each institution, no effort should be spared to establish cost-effective strategies for early detection and a clear and concise management protocol to guide actions once this complication is detected.