According to the National Center for Health Statistics, about 48 million inpatient surgical procedures are performed in the United States each year. If you add in outpatient surgeries, that number is much higher.
All surgeries carry risks of complications, which can sometimes be fatal. However, one potentially devastating complication of surgery — that is often preventable with reasonable care — is postoperative brain asphyxiation causing hypoxic or anoxic injury. In other words, catastrophic brain injury, which can be fatal or lead to catastrophic brain damage.
What is postoperative brain asphyxiation?
The brain requires a continuous flow of oxygen to function normally. If the flow of oxygen is interrupted for a certain length of time, brain damage can occur. In postoperative asphyxiation, also called a hypoxic-anoxic injury, the brain is deprived of oxygen and cells die. Hypoxia is partial oxygen deprivation, whereas Anoxia is complete oxygen deprivation.
Generally, the longer the brain is deprived of oxygen, the more severe the damage to the brain. According to Mount Sinai Hospital, usually, brain cells start to die after about four minutes without oxygen.
Symptoms of a postoperative anoxic brain injury can vary. In severe cases, symptoms can include:
- No breathing
- Brain death
If oxygen is restored to the brain quickly, less damage may occur. Mild to moderate symptoms of an anoxic brain injury may include:
- Memory loss
- Difficulty making decisions
- Trouble speaking
- Weakness in the arms or legs
Postoperative brain asphyxiation can develop immediately after surgery or several hours later. It can occur due to a variety of reasons.
For example, a lack of adequate monitoring after surgery can play a big role in postoperative brain asphyxiation. Inadequate patient management can lead to missed complications that cause a lack of oxygen to the brain. Even patients who have had procedures that are considered minor or routine can develop complications quickly, which can lead to a brain injury. Passen & Powell recently settled a case for $5.5 million against a Chicago-area hospital for failing to adequately monitor a patient post-ACDF surgery, who developed a hypoxic-anoxic brain injury. The patient should have been monitored with heart rate and oxygen saturation hardwire monitoring, but the monitors were negligently removed. When the patient’s endotracheal tube migrated into his lung, and the patient was unable to adequately breathe, the hospital staff failed to do anything about it for an hour — during which time the patient’s brain was being deprived of oxygen leading to a permanent brain injury.
Patients with surgical airways — endotracheal tubes or those on ventilators — must be safely monitored to ensure they are receiving adequate oxygen. The doctors and nursing staff must ensure that the trach was properly placed and does not migrate into one of the lungs (i.e. right mainstem bronchus intubation). Proper precautions for aspiration on vomit must be taken to protext against airway obstruction leading to hypoxic-anoxic inury.
Proper patient screening and identification of potential problems before surgery are also critical to preventing bad outcomes postoperatively. A study published in the Journal of Anesthesia & Analgesia in July 2017, indicated that low oxygen levels in adults 24 hours before having cardiac surgery increased the patient’s risk of having a stroke postoperatively, which can lead to brain asphyxiation.
Various problems can develop after surgery that can lead to brain asphyxiation including:
- Difficulty coming out of anesthesia
- Cardiac arrest
- Excessive blood loss
- Respiratory failure
Proper monitoring, identification, and treatment of medical problems both before and after surgery are important to reduce complications leading to an anoxic brain injury. Immediate recognition of a lack of oxygen to the brain is also critical to decrease damage.
Long-term effects of postoperative brain asphyxiation
It can be difficult to predict the outcome of postoperative brain asphyxiation. When the brain is only deprived of oxygen for a short time, recovery may be possible, which allows a return to full or partial functioning. But in other instances, complete recovery does not occur.
If the injury is severe, but the person survives, it may lead to a persistent vegetative state. A vegetative state means the person has basic functions, such as waking and sleeping cycles, but has no awareness. The individual may even open their eyes, but they do not show any meaningful responses or alertness.
Postoperative brain asphyxiation is an emergency and if not treated immediately will result in death. Immediate treatment involves restoring oxygen to the brain. Initial treatment often includes ventilatory support to restore breathing and oxygen to the brain. Medications may be given to increase blood pressure if it is too low.
If the person remains in a vegetative state, supportive treatment is given. Treatment may include a feeding tube, frequent repositioning to prevent bed sores and medication to decrease seizures and treat muscle spasticity.
In less severe injuries to the brain, rehabilitation services, such as physical, speech and occupational therapy may be prescribed to improve functioning.
Postoperative brain asphyxiation can have a devastating effect on the person injured, as well as family and friends. Treatment can be expensive and can often last a lifetime. Although in some cases, recovery may occur, people with post-operative brain asphyxiation frequently have substantial medical needs and costs.
If you or a loved one has suffered postoperative brain damage due to medical negligence, it is critical to contact an experienced medical negligence lawyer as soon as possible. Please call our office at 312-698-3694 for a free consultation with one of our top-rated attorneys.