[abstract] MASSIVE VENOUS GAS EMBOLISM COMPLICATING THE EVALUATION OF A TOXIC PATIENT

Rubicon Research Repository/Manakin Repository

[abstract] MASSIVE VENOUS GAS EMBOLISM COMPLICATING THE EVALUATION OF A TOXIC PATIENT

Show simple item record


dc.contributor.author Wilder, M
dc.contributor.author Gomez, J
dc.contributor.author Staab, P
dc.contributor.author Harch, P
dc.contributor.author Van Meter, K
dc.contributor.author Murphy-Lavoie, H
dc.contributor.author LeGros, T
dc.date.accessioned 2011-05-18T17:21:52Z
dc.date.available 2011-05-18T17:21:52Z
dc.date.issued 2010
dc.identifier.citation Undersea and Hyperbaric Medical Society Annual Meeting, St Pete Beach, Florida, USA. Undersea and Hyperbaric Medicine 2010 en
dc.identifier.issn 1066-2936
dc.identifier.uri http://archive.rubicon-foundation.org/9267
dc.description Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting, St Pete Beach, Florida, USA. (http://www.uhms.org) en
dc.description.abstract Hyperbaric oxygen therapy (HBO2) is an approved treatment of gas emboli and should be considered with presence of neurological and cardiovascular manifestations. A 60 y/o man who flew from Israel to New York and then from New York to New Orleans, was having dinner when he developed sudden onset of dizziness, global weakness, nausea, and diaphoresis. His BP at that time was 70/50. His medical history included DMII, HTN, glaucoma, and GERD. In the ED, his VS were: BP 70/35, HR 112, RR 14, and afebrile. He was diaphoretic with cool,clammy skin, with an intact neurological exam. The working differential included AMI, PE, AAA, aortic dissection, and sepsis. CAT scans of his chest and abdomen were remarkable for absence of a PE, AAA or dissection, but positive for a constrictive pericardial effusion and massive air within the pulmonary / thoracic venous system (iatrogenic). A stat pericardiocentesis removed 10 ml of fluid (transudate). The patient’s pressure then began deteriorating, requiring Levophed, intubation and a Propofol drip, and he was transferred to a HBO2 facility for emergent treatment. Upon arrival he coded and CPR was performed. Vitals returned and he underwent a Navy TT6. His pressure began to improve and he began purposeful movements. His cardiac ECHO showed LV enlargement and aortic root dilatation. An IV Adenosine Cardiolite Stress test was normal (EF=59%). Within 72 hours the patient was extubated, with a normal neurological exam and an unremarkable brain MRI. The patient recovered completely and returned home to Israel. A high index of suspicion for VGE is required. Immediate management includes hemodynamic support and identification of the air source to reduce amount of further air entry. Immediate treatment is desired, however, therapy may still have good results even when initiated beyond 6 hours of an embolic event. en
dc.format.extent 258 bytes
dc.format.mimetype text/plain
dc.language.iso en_US en
dc.publisher Undersea and Hyperbaric Medical Society en
dc.subject gas emboli en
dc.subject Hyperbaric oxygen therapy en
dc.subject neurological en
dc.subject cardiovascular en
dc.title [abstract] MASSIVE VENOUS GAS EMBOLISM COMPLICATING THE EVALUATION OF A TOXIC PATIENT en
dc.type Article en

Files in this item

Files Size Format View
abstract.txt 258bytes Text file View/Open

This item appears in the following Collection(s)

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

Show simple item record

Browse

My Account