CARDIAC-ARREST AND RESUSCITATION OF A 6-MONTH OLD ACHONDROPLASTIC BABY UNDERGOING NEUROSURGERY IN THE PRONE POSITION

We describe the case of a 6-month-old achondroplastic baby who underwe nt foramen magnum decompression to relieve congenital cervical cord co mpression. During the procedure, acute hypotension occurred secondary to cord compression, and following attempts to alleviate this, torrent ial haemorrhage ensued and air was entrained into the circulation thro ugh large venous channels in the surgical field. This resulted in an a systolic cardiac arrest from which the baby was resuscitated whilst re maining in the prone position. Haemorrhage remained difficult to contr ol and a second episode of air embolism occurred 5 min later leading t o a profound bradycardia and hypotension again requiring full cardiore spiratory resuscitation in the prone position. In total, 11 min elapse d before an adequate spontaneous cardiac output was re-established. Th e procedure was abandoned and the patient transferred to the intensive care unit for. postoperative management. An electroencephalogram perf ormed after 24 h was reported as normal, and clinically the child made a full neurological recovery.