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20 February 2023 : Case report  South Korea

[In Press] Systemic Venous Air Emboli After Emergent Hyperbaric Therapy for Carbon Monoxide Poisoning

Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Management of emergency care

Kyoungmi Lee1ABCDEF, In Byung Kim2B, Jae Hoon Lim3D

DOI: 10.12659/AJCR.939304

Am J Case Rep In Press; DOI: 10.12659/AJCR.939304  

Available online: 2023-02-20, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
A venous air embolism is a rare condition but could have a disastrous effect on vital organs. It usually occurs due to iatrogenic sources, such as central venous catheter insertion, neurosurgery, and other invasive procedures. In most cases, hyperbaric oxygen therapy (HBOT) is the best treatment for those conditions. However, multiple venous air emboli after hyperbaric oxygen therapy has not been reported in the literature.
CASE REPORT
An 82-yr-old woman came to the Emergency Department after inhalation of fumes at the scene of a house fire. She had dizziness and nausea. Her vital signs were normal at the time of presentation. She received HBOT for carbon monoxide poisoning. Soon after the HBOT, the patient started to have dizziness, abdominal pain, and leg pains. Computed tomography scans showed multiple systemic venous air emboli throughout the portal venous system and femoral veins. The air emboli totally disappeared after HBOT with a longer ascent time.
CONCLUSIONS
To the best of our knowledge, this is the first case of multiple systemic venous air bubbles after emergent HBOT. Physicians should be aware of any kind of complications when treating patients who need HBOT in the emergent setting. Although decompression sickness following HBOT is extremely rare, it should not be ignored by emergency physicians.

Keywords: Carbon Monoxide Poisoning; Decompression Sickness; Hyperbaric Oxygenation; Embolism, Air

SARS-CoV-2/COVID-19

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Am J Case Rep In Press; DOI: 10.12659/AJCR.938752  

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Am J Case Rep In Press; DOI: 10.12659/AJCR.938875  

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923