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

Abstract

We did not observe an effect of hyperbaric oxygenation on cerebral function after a delay of 2 or 4 hours. The injury caused in our model could be too severe for a single session of hyperbaric oxygenation to be effective. Our study should not change current hyperbaric oxygenation strategies for cerebral arterial gas embolism, but further research is necessary to elucidate our results. Whether less severe injury benefits from hyperbaric oxygenation should be investigated in models using smaller amounts of air and clinical outcome measures.

Venous air embolism during cystoscopy in standing horses

“…), although recent studies in a swine model did not demonstrate improved neurological outcomes (Weenink et al . ). Nonetheless, in equine veterinary facilities with access to a hyperbaric oxygen chamber, its use may be warranted especially if started by 6 h after air entrainment (Kjeld et al .…”

“…Treatment of VAE in horses is largely supportive (Pellegrini-Masini et al 2009), although in man attempts to aspirate air either through an existing right-sided central line positioned at the highest point of the right atrium have been described (van Hulst et al 2003). Hyperbaric oxygen therapy has long been advocated when available to speed the reabsorption of the nitrogen bubbles by increasing partial pressure of oxygen in the blood and thus increasing the partial pressure gradient of nitrogen across the alveolar membrane (Mirski et al 2007;Kjeld et al 2012), although recent studies in a swine model did not demonstrate improved neurological outcomes (Weenink et al 2013). Nonetheless, in equine veterinary facilities with access to a hyperbaric oxygen chamber, its use may be warranted especially if started by 6 h after air entrainment (Kjeld et al 2012).…”

Comments on: When neuroscience gets wet and hardcore: neurocognitive markers obtained during whole body water immersion

“…However, because there is a total submersion and there are no air cavities in the brain, there is no expectation of an increased ICP due to submersion. Our group did experiments on pigs where we measured the ICP during hyperbaric treatment to an equivalent of 18 m of seawater and we did not see a change in the ICP during this treatment (Weenink et al 2013).…”

Massive cerebral air embolism after blunt chest trauma with full neurological recovery

“…4,11 Finally, hyperbaric oxygen therapy (HBOT) is widely accepted as the ideal treatment option for systemic air embolism, although this indication is controversial. 12,13 Hyperbaric oxygenation is assumed to decrease the physical size of the bubbles and may increase bubble denitrogenation by forming a higher gradient of dissolved oxygen between the blood and the air bubble. [12][13][14][15] Logistic and transport limitations of HBOT render it impractical, and the restricted access to the patient in the hyperbaric chamber precludes its immediate use for a multitrauma patient.…”