Cardiac arrest during surgery and ventilation in the prone position: a case report and systematic review

Resuscitation. 2001 Aug;50(2):233-8. doi: 10.1016/s0300-9572(01)00362-8.


We present a case report of successful resuscitation following cardiac arrest in a patient undergoing surgery in the prone position. A systematic review of the literature identified 22 further cases. Risk factors for intra-operative cardiac arrest in patients in the prone position include: cardiac abnormalities in patients undergoing major spinal surgery, hypovolaemia, air embolism, wound irrigation with hydrogen peroxide, poor positioning and occluded venous return. Cardiac arrest is also a risk in the increasing number of patients with acute respiratory distress syndrome ventilated in the prone position. Management of prone cardiac arrest may be improved by identification of high-risk patients, careful patient positioning, use of invasive monitoring and placement of self-adhesive defibrillator paddles. Suitable techniques for cardiopulmonary resuscitation including methods for chest compression, defibrillation and the management of air embolism are discussed.

Publication types

  • Case Reports
  • Review
  • Systematic Review

MeSH terms

  • Blood Loss, Surgical
  • Cardiopulmonary Resuscitation / methods*
  • Female
  • Heart Arrest / etiology*
  • Heart Arrest / therapy
  • Humans
  • Intraoperative Complications / therapy*
  • Middle Aged
  • Prone Position
  • Risk Factors
  • Spinal Cord Compression / surgery*
  • Thoracic Vertebrae / surgery