Secondary deterioration in a patient with cerebral and coronary arterial gas embolism after brief symptom resolution : a case report
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms..
Introduction: Hyperbaric oxygen treatment (HBOT) is recommended for arterial gas embolism (AGE) with severe symptoms. However, once symptoms subside, there may be a dilemma to treat or not.
Case presentation: A 71-year-old man was noted to have a mass shadow in his left lung, and a transbronchial biopsy was performed with sedation. Flumazenil was intravenously administered at the end of the procedure. However, the patient remained comatose and developed bradycardia, hypotension, and ST-segment elevation in lead II. Although the ST changes spontaneously resolved, the patient had prolonged disorientation. Whole- body computed tomography revealed several black rounded lucencies in the left ventricle and brain, confirming AGE. The patient received oxygen and remained supine. His neurological symptoms gradually improved but worsened again, necessitating HBOT. HBOT was performed seven times, after which neurological symptoms resolved almost completely.
Conclusions: AGE can secondarily deteriorate after symptoms have subsided. We recommend that HBOT be performed promptly once severe symptoms appear, even if they resolve spontaneously.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:54 |
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| Enthalten in: |
Diving and hyperbaric medicine - 54(2024), 1 vom: 31. März, Seite 61-64 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tsushima, Ryota [VerfasserIn] |
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| Links: |
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| Themen: |
Air embolism |
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| Anmerkungen: |
Date Completed 22.03.2024 Date Revised 22.03.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.28920/dhm54.1.61-64 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM369974948 |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms. | ||
| 520 | |a Introduction: Hyperbaric oxygen treatment (HBOT) is recommended for arterial gas embolism (AGE) with severe symptoms. However, once symptoms subside, there may be a dilemma to treat or not | ||
| 520 | |a Case presentation: A 71-year-old man was noted to have a mass shadow in his left lung, and a transbronchial biopsy was performed with sedation. Flumazenil was intravenously administered at the end of the procedure. However, the patient remained comatose and developed bradycardia, hypotension, and ST-segment elevation in lead II. Although the ST changes spontaneously resolved, the patient had prolonged disorientation. Whole- body computed tomography revealed several black rounded lucencies in the left ventricle and brain, confirming AGE. The patient received oxygen and remained supine. His neurological symptoms gradually improved but worsened again, necessitating HBOT. HBOT was performed seven times, after which neurological symptoms resolved almost completely | ||
| 520 | |a Conclusions: AGE can secondarily deteriorate after symptoms have subsided. We recommend that HBOT be performed promptly once severe symptoms appear, even if they resolve spontaneously | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Air embolism | |
| 650 | 4 | |a Case reports | |
| 650 | 4 | |a Hyperbaric oxygen treatment | |
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| 700 | 1 | |a Imaki, Shohei |e verfasserin |4 aut | |
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