Boussuges A, Blanc P, Molenat F, Bergmann E, Sainty J M
Service de Réanimation Médicale et d'Hyperbarie, Hôpital Salvator, Marseille, France.
Minerva Med. 1995 Nov;86(11):453-7.
Prognosis of iatrogenic air embolism is various according to previous studies. The purpose of this study was to determine the risks factors associated with the prognosis of iatrogenic air embolism. We conducted a retrospective analysis of 113 patients treated with HBO therapy in our hyperbaric center from 1979 to 1993. Initial symptomatology consisted in neurological disorders (71% of cases), respiratory disorders (43% of cases) and hemodynamic disorders (33% of cases). When neurological disorders were observed, HBO therapy included immediate compression to 6 atm abs for 10 to 15 mn with air followed by decompression to 2 atm abs where the patients received 100% oxygen during 1 hour. When no neurological disorders was observed, HBO therapy consisted in an oxygenation for 1 h, 2 atm abs, FiO2 = 1. Overall outcome was: recovery: 69 per cent of cases, sequelae: 26 per cent of cases, death: 5 per cent of cases. Prognosis was very different according to etiologies and existence of neurological disorders. Venous emboli had a better improvement than arterial emboli. In conclusion, patterns of air embolism can be divided clinically into two major categories, cerebral and pulmonary air embolism, which should be individualised in clinical studies. The studies must also individualised etiologies.
根据以往研究，医源性空气栓塞的预后各不相同。本研究的目的是确定与医源性空气栓塞预后相关的危险因素。我们对1979年至1993年在我们高压氧中心接受高压氧治疗的113例患者进行了回顾性分析。初始症状包括神经功能障碍（71%的病例）、呼吸功能障碍（43%的病例）和血流动力学障碍（33%的病例）。当观察到神经功能障碍时，高压氧治疗包括立即加压至6个绝对大气压，持续10至15分钟，同时吸入空气，随后减压至2个绝对大气压，在此期间患者吸入100%氧气1小时。当未观察到神经功能障碍时，高压氧治疗包括在2个绝对大气压下吸氧1小时，FiO2 = 1。总体结果为：康复：69%的病例，后遗症：26%的病例，死亡：5%的病例。根据病因和神经功能障碍的存在情况，预后差异很大。静脉栓塞的改善情况优于动脉栓塞。总之，空气栓塞的类型在临床上可分为两大类，即脑空气栓塞和肺空气栓塞，在临床研究中应个体化。研究还必须对病因进行个体化分析。
