[abstract] IATROGENIC GAS EMBOLISM TREATED WITH HBOT: A CASE SERIES

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[abstract] IATROGENIC GAS EMBOLISM TREATED WITH HBOT: A CASE SERIES

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Title: [abstract] IATROGENIC GAS EMBOLISM TREATED WITH HBOT: A CASE SERIES
Author: Smith, L; Swaby, K; Valderrama, O; Suarez-Mendoza, A; Fife, CE
Abstract: BACKGROUND: Arterial gas embolism (AGE) is a primary indication for hyperbaric oxygen therapy (HBOT). Neurological deficits may also occur with large volumes of venous gas embolism (VGE) if anatomical or physiological shunting occurs. We report a series of iatrogenic AGE and VGE treated with HBOT. MATERIALS AND METHODS: Retrospective chart review of all HBOT patients treated for ICD9 diagnosis 958.0(AGE) from 2002 through 2004. RESULTS: Four patients were identified with iatrogenic AGE out of a total of 750 HBO patients. (0.005 percent). Diving related AGE was excluded. Etiological factors included: complications of liver transplant and coronary bypass operations, chronic venous access in a cancer patient and thrombolytic therapy for stroke treatment. Two other patients with venous emboli were evaluated but not treated because no neurological deficits were present. Two of four cases with neurological deficits were due to VENOUS gas infusion vs. direct arterial infusion. Average time to HBOT referral was 16.1 hours. Due to long average delay in referral, patients were treated with USN TT6. Deficits included depressed respiratory function, responsive to deep pain only and total neurologic unresponsiveness. Two of four patients improved objectively during the initial HBOT. The average number of treatments per patient was 3.5. Follow-up treatments done with 45 and 60 FSW treatment tables. No long term follow up or neuropsychometric testing was available. CONCLUSIONS: In this small series, 50percent of patients with iatrogenic AGE had a venous source for gas. Transpulmonary passage or patent foramen ovale are possible mechanisms. These 2 patients demonstrated clinical improvement even after delays to HBO treatment.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1676
Date: 2005

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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