Air or Gas Embolism

Air or gas embolism occurs when gas bubbles enter the arteries, veins and/or capillaries. This results in reduced blood flow and poor oxygen delivery to the affected areas. Gas embolism can result in death or severe, long-standing and irreversible physical and emotional disabilities. It can cause weakness or paralysis in the limbs and blindness or impaired vision. Gas embolism can also damage the brain, heart, lung and other organs.

Impairment can be sufficiently severe that total disability results and the patients may be limited to walking with canes, crutches or walkers. Those more severely disabled may be confined to a wheelchair or bedridden. These outcomes may be permanent and may severely impact the patients’ quality of life. Maximal medical treatment of the condition is necessary to ensure the best possible degree of recovery.

Hyperbaric oxygen has been shown to reduce the size of gas bubbles obstructing the circulation. The increased pressure in the hyperbaric chamber reduces bubble size and drives the remaining gas out of the circulation, while the high oxygen pressure washes out inert gas from the bubble. When bubbles are smaller or dissolved, blood flow resumes and tissues receive higher levels of oxygen delivery.

Gas embolism may also cause vessels that are obstructed by bubbles to leak fluid into the surrounding tissues, resulting in swelling. The swelling can further reduce blood flow to the tissues. When blood flow is restored through hyperbaric oxygen, the swelling will subside and circulation and oxygen supply will improve. Finally, the high levels of oxygen provided in the hyperbaric chamber have the potential to immediately restore cellular oxygen levels while blood flow impairment and tissue swelling are being treated.

Hyperbaric oxygen therapy is the primary treatment for gas embolism. A major review of reported cases clearly indicates superior outcomes with its use compared to treatment without hyperbaric oxygen.

References:

  1. Mushkat Y, Luxman D, Nachum Z, David MP, Melamed Y. Gas embolism complicating obstetric or gynecologic procedures. Case reports and review of the literature. European Journal of Obstetrics, Gynecology, & Reproductive Biology 1995;63:97-103.
  2. Boussuges A, Blanc P, Molenat F, Bergmann E, Sainty JM. Prognosis in iatrogenic gas embolism. Minerva Medica 1995;86:453-457.
  3. Weiss LD, Van Meter KW. The applications of hyperbaric oxygen therapy in emergency medicine. American Journal of Emergency Medicine 1992;10:558-568.
  4. Kindwall EP. Uses of hyperbaric oxygen therapy in the 1990s. Cleveland Clinic Journal of Medicine. 1992;59:517-528.
  5. Dutka AJ. Air or gas embolism. In: Hyperbaric Oxygen Therapy: A Critical Review. Camporesi EM, Barker AC, eds. Bethesda, MD, Undersea and Hyperbaric Medical Society, 1991:1-10.
Center for Hyperbaric Medicine