Document Detail

Recommendations for hyperbaric oxygen therapy of cerebral air embolism based on a mathematical model of bubble absorption.
MedLine Citation:
PMID:  9174293     Owner:  NLM     Status:  MEDLINE    
Transcranial doppler studies show that microscopic cerebral artery air emboli (CAAE) are present in virtually all patients undergoing cardiac surgery. Massive cerebral arterial air embolism is rare. If it occurs, hyperbaric oxygen therapy (HBO) is recommended as soon as surgery is completed. We used a mathematical model to predict the absorption time of CAAE, assuming that the volumes of clinically relevant CAAE vary from 10(-7) to at least 10(-1) mL. Absorption times are predicted to be at least 40 h during oxygenation using breathing gas mixtures of fraction of inspired oxygen approximately equal to 40%. When CAAE are large enough to be detected by computerized tomography, absorption times are calculated to be at least 15 h. Decreases in cerebral blood flow caused by the CAAE would make the absorption even slower. Our analysis suggests that if the diagnosis of massive CAAE is suspected, computerized tomography should be performed, and consideration should be given to HBO therapy if the CAAE are large enough to be visualized, even if patient transfer to a HBO facility will require several hours.
F Dexter; B J Hindman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  84     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-06-25     Completed Date:  1997-06-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1203-7     Citation Subset:  AIM; IM; S    
Department of Anesthesia, University of Iowa, Iowa City 52242, USA.
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MeSH Terms
Cerebral Arterial Diseases / metabolism*,  therapy*
Embolism, Air / metabolism*,  therapy*
Hyperbaric Oxygenation / methods*
Mathematical Computing
Models, Biological*
Nitrogen / blood
Partial Pressure
Reg. No./Substance:

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