CT Demonstration of Massive Cerebral Air Embolism from Pulmonary Barotrauma due to Cardiopulmonary Resuscitation

Yamaki, Toshiaki; Ando, Shinya; Ohta, K.; Kubota, Tomotsugu; Kawasaki, Koichi; Hirama, Motohiro

doi:10.1097/00004728-198903000-00024

Cited by 30 publications

(12 citation statements)

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“…We postulate that such a condition of air entrainment may have occurred during the cardiopulmonary resuscitation procedure. However, there is limited literature available of air embolism following cardiopulmonary resuscitation (3)(4)(5)(6)(7)(8). Of these, the majority refers to cerebral air emboli following head injuries.…”

Section: Discussionmentioning

confidence: 99%

Systemic air embolism after cardiopulmonary resuscitation in a preterm infant

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Systemic air embolism after cardiopulmonary resuscitation in a preterm infant

et al. 2008

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“…b PMCT of the thorax shows spotty gas in the ascending aorta (arrow) cerebral arteries. [26][27][28][29][30][31][32][33] In our study, three subjects with cerebral arterial GE were pediatric cases. Arterial GE in pediatric cases can be theoretically explained as paradoxical embolism.…”

Section: Discussionmentioning

confidence: 78%

“…19,20 Cerebral gas embolism (GE) is thought to occur accidentally, [21][22][23] iatrogenically, 24,25 and as a result of cardiopulmonary resuscitation (CPR) after CPA. [26][27][28][29][30][31][32][33][34][35] On PMCT imaged immediately before or after death in traumatically deceased cases, only arterial fi ndings of cerebral GE due to CPR have been reported. [27][28][29][30][31][32][33] In contrast, both arterial and venous GE fi ndings have been reported in nontraumatically deceased cases.…”

Section: Introductionmentioning

confidence: 99%

“…[27][28][29][30][31][32][33] In contrast, both arterial and venous GE fi ndings have been reported in nontraumatically deceased cases. 26,27,34,35 Any analysis of cerebral GE induced by CPR should exclude the possible effects of trauma. However, the published literature on the subject is limited, and the nature of GE remains unclear with regard to its frequency of occurrence and whether it occurs more commonly in arteries or veins.…”

Section: Introductionmentioning

confidence: 99%

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Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation

et al. 2010

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“…Although diagnosis of cerebral air embolism depends on the clinical history and physical examination, some studies using computed tomography (CT) and magnetic resonance imaging (MRI) have demonstrated air in the cerebral vasculature that correlated with clinical evidence of neurologic injury [27,28]. Kizer [29] found that CT was helpful in the assessment of patients after recompression therapy of air embolism.…”

Section: Pulmonary Barotrauma and Air Embolismmentioning

confidence: 99%

Medical Disorders Related to Diving

Bové

2002

J Intensive Care Med

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Exposure to the underwater environment is associated with several unique disorders that may require recompression in a hyperbaric chamber. Increasing pressure during descent reduces the volume of the paranasal sinuses and middle ear, which, if not properly equalized, will sustain injury due to barotrauma. Barotrauma of the inner ear results in vertigo, tinnitus, and often permanent hearing loss. During ascent, expanding gas can produce lung injury accompanied by pneumothorax, mediastinal and subcutaneous emphysema, injection of air into the pulmonary veins, and arterial air embolism to the brain. Divers with pulmonary barotrauma often present with unconsciousness, seizures, or other evidence of cerebral dysfunction. Rapid treatment with recompression often reverses the cerebral deficits. Air embolism lesions are usually diffuse, in contradistinction to a stroke which usually follows the distribution of a single cerebral artery. Decompression sickness is a disorder caused by evolution of supersaturated dissolved gas in tissues and blood following exposure to increased pressure. Protocols for avoiding excess supersaturation during ascent from depth have been available for more than 100 years, and diving is considered safe when established decompression schedules are followed. Decompression sickness causes pain in the joints of the upper and lower extremities, and can injure the spinal cord. Paralysis, paresthesias, sensory loss, and bowel and bladder paralysis accompany spinal cord injury. Treatment involves recompression and oxygen. Platelet inhibitors and other anti‐inflammatory drugs are also useful. A diving disorder must be considered in any patient with a neurologic syndrome, vertigo, hearing loss, or joint pain following diving.

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CT Demonstration of Massive Cerebral Air Embolism from Pulmonary Barotrauma due to Cardiopulmonary Resuscitation

Cited by 30 publications

References 0 publications

Systemic air embolism after cardiopulmonary resuscitation in a preterm infant

Systemic air embolism after cardiopulmonary resuscitation in a preterm infant

Nontraumatic postmortem computed tomographic demonstration of cerebral gas embolism following cardiopulmonary resuscitation

Medical Disorders Related to Diving

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