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Title: Pneumothorax as a complication of recompression therapy for cerebral arterial gas embolism
Authors: Broome, JR
Smith, DJ
Keywords: submarine
thoracentesis
pulmonary
embolism
AGE
air
chamber
pneumothorax
barotrauma
case report
Issue Date: 1992
Abstract: The danger from pneumothorax in patients who undergo compression chamber treatment for cerebral arterial gas embolism (CAGE) following pulmonary barotrauma is frequently emphasized. Two cases of CAGE treated by recompression after submarine escape tank training (SETT) accidents are described. Both were complicated by bilateral pneumothoraces but the first case, treated on an air table, required thoracentesis in the chamber, whereas the second case, treated on an oxygen table, escaped the need for in-chamber thoracentesis despite large pneumothoraces. Review of similar Royal Navy and United States Navy SETT accidents suggests that the danger from pneumothorax during recompression treatment of CAGE victims may be overstated. Modern management on oxygen-based therapeutic recompression tables may significantly reduce the risk. Thoracentesis while under pressure should be reserved for cases developing symptoms or signs of tension pneumothorax. Treatment options for these cases are discussed and a decision algorithm is proposed.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: PMID: 1304671
http://archive.rubicon-foundation.org/2600
Appears in Collections:Undersea Biomedical Research Journal

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