[abstract] IATROGENIC VENOUS EMBOLISM CAUSING CARDIAC ARREST SUCCESSFULLY TREATED WITH HYPERBARIC OXYGEN

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[abstract] IATROGENIC VENOUS EMBOLISM CAUSING CARDIAC ARREST SUCCESSFULLY TREATED WITH HYPERBARIC OXYGEN

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Title: [abstract] IATROGENIC VENOUS EMBOLISM CAUSING CARDIAC ARREST SUCCESSFULLY TREATED WITH HYPERBARIC OXYGEN
Author: Voigt, M; Carbonaro, D; Jacoby, I; Witucki, P
Abstract: BACKGROUND: Gas emboli result from gas entry into the vascular system. This entry can result from gas introduced into the venous or arterial systems. Venous emboli can occur as a consequence of routine medical procedures including placement or removal of central vascular access devices. An estimated lethal dose of air in dog studies is 7.5 mL/kg. Case reports of accidental injections in humans suggest the lethal volume of gas is approximately 3-5 mL/kg. This amount of gas can lead to complete ventricular outflow obstruction and cardiovascular collapse as well as arterialization of air and AGE. There is a wide spectrum of clinical presentations from benign to cardiovascular collapse. The true incidence of this disease process is unknown due to the fact that many cases are sub-clinical. We report a case of massive venous embolism and cardiovascular collapse successfully treated with HBOT. CASE REPORT: A 29 year old male became unresponsive during the difficult removal of his central venous catheter used for chemotherapy. He was found to be in cardiac arrest and was resuscitated using advanced cardiac life support. Large amounts of intra-cardiac air were reported on bedside ultrasound. The patient demonstrated focal neurologic deficits and posturing and was transferred for hyperbaric oxygen therapy. He underwent treatment utilizing US Navy treatment table 6 with full extensions. He stabilized and subsequently regained full neurologic function. CONCLUSIONS: Venous gas embolism can result from many medical interventions. Treatment for venous gas emboli is primarily supportive. Aggressive CPR and ACLS have been effective in several reported cases where cardiopulmonary arrest has occurred. HBOT is indicated in patients with persistent cardiovascular instability, persistent neurological deficit, or with evidence of secondary arterial gas embolism.
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting, Las Vegas, Nevada, USA. (http://www.uhms.org)
URI: http://archive.rubicon-foundation.org/9148
Date: 2009

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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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