[abstract] TWO CASES OF IATROGENIC GAS EMBOLISM SUCCESSFULLY TREATED WITH DELAYED HYPERBARIC OXYGEN THERAPY

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[abstract] TWO CASES OF IATROGENIC GAS EMBOLISM SUCCESSFULLY TREATED WITH DELAYED HYPERBARIC OXYGEN THERAPY

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Title: [abstract] TWO CASES OF IATROGENIC GAS EMBOLISM SUCCESSFULLY TREATED WITH DELAYED HYPERBARIC OXYGEN THERAPY
Author: Glover, N; Shapshak, D; Cianci, PE
Abstract: BACKGROUND: Gas embolism, the entry of gas into vascular structures, is a rare iatrogenic clinical problem that can complicate procedures in multiple clinical specialties. We report two iatrogenic gas embolism cases with greater than 6 hours of delay from onset to successful treatment with Hyperbaric Oxygen TherapCASE STUDY 1: A 28-year-old law student underwent a laproscopic cholecystectomy. Cardiovascular collapse occurred immediately following insufflation of the peritoneal cavity. Neurologic exam revealed decorticate posturing, and after several hours of treatment in the ICU, neurologic function further declined to flaccid paralysis. HBO therapy was then considered for Arterial Gas Embolism. The patient received a Short Oxygen table (30 minutes at 3.0ATA followed by 60 minutes at 2.5ATA) approximately 12 to 14 hours after incurring the insult. Daily tailing treatments (120 minutes at 2.0ATA) followed, and after three treatments, extubation occurred without residual focal neurologic deficits. Nine total HBO treatments provided excellent recovery and she subsequently completed her degreCASE STUDY 2: A 54-year-old female underwent coiling of a left internal carotid artery aneurism. A flush device malfunctioned, injecting air directly into the artery. Angiogram revealed gas in the distal left middle cerebral artery circulation. The patient was transferred to the ICU where neurologic exam revealed posturing and a flat EEG. Hyperbaric Oxygen Therapy was initiated with a US Navy Treatment Table 6 approximately 7 hours after AGE occurrence. Daily tailing treatments (2.0ATA for 120 minutes) followed. The patient was extubated after treatment 4 with the ability to follow simple commands. The patient received a total of 10 HBO treatments; full neurologic recovery was obtaineCONCLUSIONS: The entry of gas into the arterial system is a risk in many clinical procedures. Despite long delays in diagnosis and treatment that often occur with AGE, HBO is still an effective treatment to preserve life and function.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/3767
Date: 2006

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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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