The effect of jugular vein compression as a prophylactic measure of air embolism

Evaluation by continuous measurement of the pressure near the superior bulbus of the internal jugular vein

Abstract

Early diagnosis and the prevention of the development of air enbolism are important when neurosurgery is performed in the sitting position. The authors studied the effect of jugular vein compression as a prophylactic measure of air embolism in two cases. The effect was evaluated by continuous measurement of the pressure near the superior bulbus of the internal jugular vein (IJVP). The neck was compressed until the IJVP was slightly positive. We also studied the effect of abdominal compression and positive end -expiratory pressure (PEEP10cmH₂O) as compared with neck compression. The results were as follows: 1) Air embolism could be prevented by neck compression. 2) Neck compression easily raised the IJVP above atmospheric pressure. 3) Abdominal compression and PEEP could not increase the IJVP above atmospheric pressure. Therefore, it was concluded that only neck compression was effective for raising the IJVP enough for the prevention of air embolism. Measurement of the IJVP may be useful for evaluating air embolism prophylaxis.