Jugular Bulb Pressure in Surgery of Patients in Sitting Position

Background. The pressure in brain sinuses (BSP) is used to monitor the effectiveness of various methods of prevention and treatment of venous air embolism (VAE) during surgeries in patients in the sitting position. A simpler and more approachable way is to measure the pressure in the superior bulb of the jugular vein (JBP), which accurately reflects the BSP. The dependence of the frequency and severity of VAE in JBP, however, has not been investigated, and the data on the effect of various methods of prevention and treatment of VAE on JBP are either insufficient or contradictory. The study was aimed to determine the dynamics of the JBP when bringing the patient to a sitting position, its relation with the severity of the VAE and to assess the effect of right atrium pressure (RAP), positive end expiratory pressure (PEEP) and decreased minute pulmonary ventilation (MPV) on it. Material and methods . The prospective study included 66 people who underwent intracranial surgery in a sitting position. In addition to the standard monitoring under general anesthesia with artificial lung ventilation, the superior bulb of the jugular vein and the right atrium were catheterized, and the esophagus was intubated with transesophageal echocardiography sensor. JBP was measured in a supine and sitting position and examined in relationship to RAP. In patients with JBP