[abstract]HYPERBARIC OXYGEN THERAPY AND THERAPEUTIC HYPOTHERMIA IN TREATMENT OF ARTERIAL GAS EMBOLISMS

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[abstract]HYPERBARIC OXYGEN THERAPY AND THERAPEUTIC HYPOTHERMIA IN TREATMENT OF ARTERIAL GAS EMBOLISMS

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Title: [abstract]HYPERBARIC OXYGEN THERAPY AND THERAPEUTIC HYPOTHERMIA IN TREATMENT OF ARTERIAL GAS EMBOLISMS
Author: Chin WC; Talati NT; Yang KY; Miya JM; Sprau SS
Abstract: Introduction/Background: Arterial gas embolism (AGE) is a serious complication of open heart surgery. Hyperbaric oxygen therapy (HBO2T) is considered the only effective treatment for AGE. Therapeutic hypothermia (TH) is used in the treatment of hypoxic brain injury but is not typically used for AGE. We present a case in which both HBO2T and TH were used to treat AGE. Materials and methods: Patient was a 23 year-old female with history of tetralogy of Fallot, pulmonary hypertension and stenotic pulmonary homograft, undergoing pulmonary valve replacement and PA conduit. Toward the end of the procedure, transesophageal echocardiogram presented air in the LV. The patient was placed in Trendelenburg, and the air was aspirated using a long needle. Postoperative EEG indicated diffuse slowing consistent with anoxic brain injury. The patient was tapered off sedation but was unarousable for exam. Results: Five hours post-op, HBO2T was initiated according to U.S. Navy Treatment Table 5 (TT5). After treatment, 24-hour TH protocol was initiated, with a goal temperature of 33 degrees C, utilizing Arctic SunTM. The following day, she received TT6. MRI revealed extensive infarctions along cortical ribbons of bilateral cerebral hemispheres. Postoperative Day 2 (POD), patient underwent TT5, totaling three treatments. During each HBO2T, the patient was kept cool, with ice bags over the groin and head. Conclusions: POD 4, patient consistently followed commands, and on POD 5 patient was extubated. POD 7, patient was awake, alert and interactive. Patient had considerable muscle strength in her lower extremity, but lacked strength throughout her upper extremity. Improvement continued, and by POD 13 patient could feed herself using the right arm and lift the left arm from the shoulder. She was discharged and transferred for continued physical therapy. 52 days later, patient is back in university, with no noticeable neurological change.
Description: Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc.
URI: http://archive.rubicon-foundation.org/10511
Date: 2012

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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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