Delayed hyperbaric oxygen therapy for severe arterial gas embolism following scuba diving: a case report

2019 ◽  
pp. 197-202
Author(s):  
Charlotte Sadler ◽  
◽  
Emi Latham ◽  
Melanie Hollidge ◽  
Benjamin Boni ◽  
...  
Keyword(s):  
Critically Ill ◽  
Hyperbaric Oxygen ◽  
Shortness Of Breath ◽  
Gas Embolism ◽  
Significant Delay ◽  
Pulmonary Barotrauma ◽  
Arterial Gas Embolism ◽  
History Of ◽  
Rapid Ascent ◽  
Hbo2 Therapy

We present the case of a 42-year-old female who was critically ill due to an arterial gas embolism (AGE) she experienced while diving in Maui, Hawaii. She presented with shortness of breath and dizziness shortly after surfacing from a scuba dive and then rapidly lost consciousness. The diver then had a complicated hospital course: persistent hypoxemia (likely secondary to aspiration) requiring intubation; markedly elevated creatine kinase; atrial fibrillation requiring cardioversion; and slow neurologic improvement. She had encountered significant delay in treatment due to lack of availability of local hyperbaric oxygen (HBO2) therapy. Our case illustrates many of the complications that can occur when a patient suffers a severe AGE. These cases may occur even without a history of rapid ascent or risk factors for pulmonary barotrauma, and it is imperative that they be recognized and treated as quickly as possible with HBO2. Unfortunately, our case also highlights the challenges in treating critically ill divers, particularly with the growing shortage of 24/7 hyperbaric chambers able to treat these ICU-level patients.

scholarly journals Pulmonary barotrauma with cerebral arterial gas embolism from a depth of 0.75−1.2 metres of fresh water or less: A case report

2021 ◽  
Vol 51 (2) ◽  
pp. 224-226
Author(s):  
Ulrika Lindblom ◽  
◽  
Carl Tosterud ◽  
◽  
Keyword(s):  
Hyperbaric Oxygen ◽  
Case Reports ◽  
Escape Training ◽  
Gas Embolism ◽  
Hyperbaric Oxygen Treatment ◽  
Pulmonary Barotrauma ◽  
Altered Level ◽  
Oxygen Treatment ◽  
Arterial Gas Embolism ◽  
Level Of Consciousness

During underwater vehicle escape training with compressed air, a fit 26-year-old soldier suffered pulmonary barotrauma with cerebral arterial gas embolism after surfacing from a depth of 0.75–1.2 metres of freshwater or less. She presented with an altered level of consciousness. Rapid neurological examination noted slurred speech, a sensory deficit and right hemiparesis. Eleven hours after the accident, hyperbaric oxygen treatment was initiated using US Navy Treatment Table 6. The soldier almost completely recovered after repeated hyperbaric oxygen treatment. Given the very shallow depth this is an unusual case with only two similar case reports published previously.

Operation of a hyperbaric oxygen therapy center in Korea: Report of our experience from a setting in its nascent stages

2019 ◽  
pp. 135-143
Author(s):  
Yoon Seop Kim ◽  
Yoonsuk Lee ◽  
Sun Ju Kim ◽  
Sung Oh Hwang ◽  
Yong Sung Cha ◽  
...  
Keyword(s):  
Critically Ill ◽  
Hyperbaric Oxygen ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Developed Countries ◽  
The United States ◽  
Medical Society ◽  
Hyperbaric Medicine ◽  
Therapy Center ◽  
Hbo2 Therapy

Purpose: Hyperbaric medicine is nascent in Korea when compared to other developed countries, such as the United States and Japan. Our facility has been managed by physicians with certifications from the Undersea and Hyperbaric Medical Society (UHMS) and National Oceanic and Atmospheric Administration in diving and clinical diseases since October 2016. This study was conducted to share similar issues that are encountered during the establishment of a program in a new area through our experiences in the operation of a hyperbaric oxygen (HBO2) therapy center. Methods: In this retrospective observational study we collected data on HBO2 patients treated at our center between October 2016 and June 2018 after HBO2 was conducted by HBO2-certified physicians. We then compared demographic data of patients with data from January 2011 to September 2015 – before HBO2 operations were conducted by HBO2-certified physicians. Result: A total of 692 patients received 5,130 treatments. Twelve indicated diseases were treated using HBO2 therapy. Fifty-six critically ill patients with intubation received HBO2. Although two patients experienced seizure due to oxygen toxicity during the study period, certified physicians and inside attendant took immediate corrective action. Conclusion: After the establishment of the HBO2 center operated by physicians with certification, more patients, including critically ill patients, received HBO2 safely for various diseases. In order to improve the practice of hyperbaric medicine in Korea, the Korean Academy of Undersea and Hyperbaric Medicine (KAUHM), an advanced and well-organized academic society, should communicate often with HBO2 centers, with the aim to set Korean education programs at UHMS course levels and increase reimbursement for HBO2 therapy.

Seizure during hyperbaric oxygen therapy: experience at a single academic hospital in Korea

2021 ◽  
pp. 43-51
Author(s):  
Chan Hee Lee ◽  
◽  
Jin Geul Choi ◽  
Yoonsuk Lee ◽  
Hyun Kim ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Hyperbaric Oxygen ◽  
Oxygen Therapy ◽  
Co Poisoning ◽  
Gas Embolism ◽  
Academic Hospital ◽  
Similar Frequency ◽  
Hyperbaric Medicine ◽  
Therapy Sessions ◽  
Hbo2 Therapy

Background: Hyperbaric oxygen (HBO2) therapy is a safe and well-tolerated treatment modality. Seizures, one of the most severe central nervous system side effects of HBO2 therapy, can occur. Episodes of seizures during HBO2 therapy have not yet been reported in countries such as Korea, where hyperbaric medicine is still in the developmental stage. Methods: The registry data of all patients treated with HBO2 therapy in a tertiary academic hospital in Korea were prospectively collected, and patients who developed seizures during HBO2 therapy between October 2016 and December 2019 were evaluated. In addition, we reviewed previous studies on occurrence of seizures during HBO2 therapy. Results: During the study period, a total of 10,425 treatments were provided to 1,308 patients. The most frequently treated indication was carbon monoxide (CO) poisoning ABSTRACT (n=547, 41.8%). During the HBO2 therapy sessions (total: 10,425), five seizure episodes occurred (patients with CO poisoning: n=4; patients with arterial gas embolism [AGE]: n=1). The frequency of seizures in patients with CO poisoning (0.148%) and AGE (3.448%) was significantly higher than that in patients with all indications (0.048%) (p=0.001). None of the patients had lasting effects due to the seizures. Conclusion: Our study revealed a similar frequency rate in terms of all indications and CO poisoning, and a slightly higher rate in AGE. Seizures were observed in patients with CO poisoning and AGE. Therefore, if clinicians plan to operate a hyperbaric center in a country like Korea, where there are several patients with acute CO poisoning, they should be prepared to handle seizures that may occur during HBO2 therapy.

Hyperbaric oxygen therapy for iatrogenic arterial gas embolism after CT-guided lung biopsy

2019 ◽  
Vol 68 (7) ◽  
pp. 456-460
Author(s):  
L. Hellinger ◽  
A. M. Keppler ◽  
H. Schoeppenthau ◽  
J. Perras ◽  
R. Bender
Keyword(s):  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygen Therapy ◽  
Lung Biopsy ◽  
Oxygen Therapy ◽  
Gas Embolism ◽  
Ct Guided ◽  
Arterial Gas Embolism

scholarly journals Loss of consciousness on uneventful surfacing. Two probable cases of dysbaric arterial gas embolism without apparent pulmonary barotrauma.

1993 ◽  
Vol 4 (3) ◽  
pp. 235-241
Author(s):  
Toshihiko Hidaka ◽  
Tomosumi Ikeda ◽  
Jun Taguchi ◽  
Kazuhiro Fujino ◽  
Terumasa Nagase ◽  
...  
Keyword(s):  
Loss Of Consciousness ◽  
Gas Embolism ◽  
Pulmonary Barotrauma ◽  
Arterial Gas Embolism

Hyperbaric Oxygen Does Not Improve Cerebral Function When Started 2 or 4 Hours After Cerebral Arterial Gas Embolism in Swine*

2013 ◽  
Vol 41 (7) ◽  
pp. 1719-1727 ◽  
Author(s):  
Robert P. Weenink ◽  
Markus W. Hollmann ◽  
Xavier C. E. Vrijdag ◽  
Krijn P. Van Lienden ◽  
Diederick W. De Boo ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Gas Embolism ◽  
Cerebral Function ◽  
Arterial Gas Embolism

Decompression sickness responsive to delayed treatment with hyperbaric oxygen: a case report of two divers

2020 ◽  
pp. 551-554
Author(s):  
Amy L. Inman ◽  
◽  
Lana P. Sorrell ◽  
Anthony T. Lagina ◽  
◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Standard Treatment ◽  
Clinical Symptoms ◽  
Decompression Sickness ◽  
Scuba Diving ◽  
Gas Embolism ◽  
Delayed Treatment ◽  
Cardiopulmonary Complications ◽  
Recreational Scuba ◽  
Hbo2 Therapy

With the increasing popularity of recreational scuba diving, rare complications are becoming more commonly encountered. Although diving is generally safe, novice divers may be unfamiliar with the potential hazards of scuba diving and the resulting sequelae. Dive-related injuries are commonly due to barotrauma or from breathing gas at increased pressures, resulting in decompression illness (DCI), a term that includes both decompression sickness (DCS) and arterial gas embolism (AGE). Symptoms can range from minor aches and pains to neurologic or cardiopulmonary complications resulting in death. Clinical symptoms and diagnosis may initially go unrecognized and can present in a delayed manner, often remote to the diving location. When DCI is suspected standard treatment with hyperbaric oxygen (HBO2) therapy should be considered immediately. Current literature questions the efficacy of delayed HBO2 therapy longer than 24-48 hours after symptom onset. Here we present a case of two divers who simultaneously experienced DCS and were both successfully treated after receiving delayed HBO2 therapy nearly eight days after initiation of symptoms.

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