[abstract] MONOPLACE HBO TREATMENT OF IATROGENIC AGE: REPORT OF A CASE.

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[abstract] MONOPLACE HBO TREATMENT OF IATROGENIC AGE: REPORT OF A CASE.

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Title: [abstract] MONOPLACE HBO TREATMENT OF IATROGENIC AGE: REPORT OF A CASE.
Author: Mascia, M; Brandt, B; Josefsen, L; Thurston, S; Camporesi, EM
Abstract: BACKGROUND' Iatrogenic arterial gas embolism (AGE) during cardiopulmonary by-pass (CPB) is difficult to diagnose. We describe a successful monoplace HBO treatment, after AGE following CPB. METHODS' A 57 year old lady with Marfan's syndrome, sip aortic valve replacement x 2 received surgical repair of a perivalvular aortic leak, and closure of a ventricular septal defect. Bypass time was long, with 42 min of intermittent circulatory arrest. The patient was hemodynamically stable on arrival in the ICU. Hyperbaric oxygen consultation was requested the next morning because the patient was showing focal and generalized seizures and did not wake up as expected from anesthesia. The patient was hemodynamically unstable, minimally responsive (GCS5) and continued R arm clonic seizures. She was resuscitated, treated with diazepam and diphenylhydantoin, and a transesophageal echo was obtained to exclude pericardial tamponade. Subsequently the patient was moved to the hyperbaric chamber on dopamine and dobutamine infusions (each at 10 meg/kg/min) with l.a., p.a. and arterial catheters, and endotracheal and chest tubes in place. She was recompressed on 02 at 3 ata x 30 min and 2.5 ata for 60 min and required volume resuscitation during decompression. She did not improve after the first treatment. Subsequent CT showed no brain infarcts. During tree subsequent treatments (2 ata x 90 min next 2 days) no adverse events were encountered and subsequently the patient was noted to open her eyes, to have purposeful right sided activity and no seizures. RESULTS' On the fourth day the patient was alert and oriented, with no focal weakness. She continued to recover and was extubated and discharged for rehabilitation. CONCLUSIONS; Hemodynamic instability does not preclude HBO treatment in a monoplace chamber, if patients are appropriately monitored. Absence of infarction on CT scan is reassuring and encourages continuing treatment.
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting held June 22-26, 1994. Westin Hotel, Denver, Colorado (http://www.uhms.org)
URI: http://archive.rubicon-foundation.org/5641
Date: 1994

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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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