Acute Gas Embolism - Adventist HealthCare

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Gas Embolism, Acute


Recompression in a hyperbaric chamber is the treatment of choice after gas emboli are introduced into the arterial or venous system. This includes emboli arising from diving, surgery, diagnostic procedures, gynecologic manipulations, or renal dialysis. In heart surgery, Stoney, et al.,  found 429 cases over a 5-year period in 375,000 perfusions. Treatment must be initiated during the acute period, but while results are better if recompression is within minutes after the incident, cases which recovered with treatment hours later make a trial of recompression mandatory, even in late cases. Diving medicine physicians now recognize that repeat hyperbaric oxygen treatments may hasten resolution of residual signs in some cases. Peer review is required after 10-14 treatments.


Intravascular gas emboli can be forced into solution when chamber pressure is elevated. In addition, an environment of 100% oxygen results in dissolution of bubbles by gas exchange. In the central nervous system, those cells which are viable but cannot function in a low flow state can be expected to resume function when flow is  thus increased. Irreversibly damaged neural elements will result in permanent damage. Observation of further improvement during repeat hyperbaric oxygen treatments has led to acceptance of this practice, although the exact mechanism of action is not clear.

Cost Impact

The treatment of choice for gas embolism from any cause is recompression therapy. Prevention of permanent neurologic or myocardial ischemic sequelae will represent vast savings to the health care system.

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