[abstract] NOVEL FINDINGS IN DECOMPRESSION ILLNESS (DCI) USING TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE).

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[abstract] NOVEL FINDINGS IN DECOMPRESSION ILLNESS (DCI) USING TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE).

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Title: [abstract] NOVEL FINDINGS IN DECOMPRESSION ILLNESS (DCI) USING TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE).
Author: Butler, BD; Powell, MR; Morris, WP
Abstract: BACKGR0UND: Transesophageal echocardiography represents a minimally invasive diagnostic ultrasonic device that is useful for evaluation of DCI by its ability to image venous gas emboli (VGE) and provide certain hemodynamic measures, including velocity, flow and dimensional analysis. Its correlation with conventional Doppler monitoring of decompression-induced VGE is minimally reported. METHODS: We describe the use of TEE in experimental dogs after decompression (60 fsw/120 min, 2 min to surface) in which Spencer Grade 4 bubbles were recorded using simultaneous continuous wave Doppler. RESULTS: Our observations, in addition to that of abundant VGE in the pulmonary artery and right heart involve several novel findings. These include; 1) extensive VGE entering the liver via the portal vein with complete removal, evidenced by total omission of bubble images in the hepatic vein in 5 out of 5 dogs, 2) recurrent and significant accumulation of large numbers of VGE in upper regions of the inferior vena cava (IVC) and 3) a preponderance of VGE in the microcirculation of the bowel, that exceeded those released by flexion of the lower limbs, in conditions of increased perfusion as occur with food stimulation prior to decompression. CONCLUSION: Our findings raise several questions regarding 1) the likelihood of the liver as a second target organ, other than the lungs, for DCI-induced VGE, 2) the possibility that accumulation of VGE in the IVC create a wet-foam matrix which may further induce certain blood coagulopathies and 3) that delayed release of VGE may be due in part to 1 and 2. These findings further suggest that TEE, in addition to detecting precordial VGE and transatrial blood flow via a patent foramen ovale, if present, can elucidate lessor known features of DCI that are difficult to delineate otherwise. Supported in part by NASA, NAG 9-215 & NCC9-20.
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting held July 7-10, 1993. World Trade and Convention Centre, Halifax, Nova Scotia, Canada. (http://www.uhms.org)
URI: http://archive.rubicon-foundation.org/8210
Date: 1993

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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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