Hyperbaric oxygen therapy for arterial air embolism
| Autor: | Zubin N. Balsara, Deland D. Burks |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
Resuscitation medicine.medical_specialty medicine.medical_treatment Lung biopsy Radiography Interventional Air embolism law.invention law medicine Cardiopulmonary bypass Intubation Embolism Air Humans Radiology Nuclear Medicine and imaging Embolization Lung Aged Hyperbaric Oxygenation business.industry Biopsy Needle Cerebral hypoxia General Medicine medicine.disease Cardiac surgery Anesthesia business Tomography X-Ray Computed Tomography Emission-Computed |
| Zdroj: | AJR. American journal of roentgenology. 188(1) |
| ISSN: | 1546-3141 |
| Popis: | Hyperbaric Oxygen Therapy for Arterial Air Embolism In the case conference on percutaneous lung biopsy [1], Maher and colleagues discussed the treatment of arterial air embolism. Their management included administration of 100% oxygen and placement of the patient in the left lateral position to confine the air to the right heart. The positioning of a patient in the left lateral decubitus with the head down (Trendelenberg’s) position is generally accepted as treatment for venous air embolism, not for arterial air embolism [2]. The air embolism of concern in percutaneous lung biopsy is of the arterial type. The authors also failed to mention the use of hyperbaric oxygen therapy. Although not part of immediate resuscitation, expeditious use of hyperbaric oxygen therapy is presently the treatment of choice for arterial air embolism. Arterial air embolism can have fatal consequences, particularly when air embolizes to the coronary or cerebral circulation. This condition is more commonly encountered in cardiac operations with the use of cardiopulmonary bypass. Hyperbaric oxygen therapy is the accepted mode of treatment for arterial air embolization related to cardiac surgery [3]. Hyperbaric oxygen therapy is also the specific therapy for patients with arterial air embolism who are undergoing percutaneous lung biopsy. Illustrating this point, in one series, study four of five patients suffering from air embolism after percutaneous lung biopsy who received hyperbaric oxygen therapy recovered, but four of seven patients who received no hyperbaric therapy died [4]. Initial treatment of arterial air embolization includes maximal oxygenation, addressing the patient's hemodynamic status and cardiovascular compromise. Oxygenation can be provided with a tight-fitting mask or intubation. If the patient is somnolent or unresponsive, intubation allows airway control, ventilation, and application of 100% oxygen. Cerebral hypoxia or anoxia can lead to seizures that may not respond to benzodiazepines. The use of steroids and positioning the patient in a steep Trendelenberg’s and right lateral decubitus are controversial but recommended by many [4]. After stabilizing the patient, immediate transport to a hyperbaric oxygen chamber should be arranged. (Note: Subsequent to submission of this letter to the editor, a new case report has been published on this topic [5].) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|