Systemic Venous Air Emboli After Emergent Hyperbaric Therapy for Carbon Monoxide Poisoning

Area of Science:

• Emergency Medicine
• Hyperbaric Medicine
• Vascular Complications

Background:

• Venous air embolism is a rare but serious condition, often iatrogenic.
• Hyperbaric oxygen therapy (HBOT) is a primary treatment for conditions like carbon monoxide poisoning.
• Multiple venous air emboli post-HBOT is an unreported phenomenon.

Observation:

• An 82-year-old female presented with carbon monoxide poisoning and received HBOT.
• Post-HBOT, the patient developed symptoms including dizziness, abdominal, and leg pain.
• CT scans revealed multiple systemic venous air emboli in the portal and femoral veins.

Findings:

• This is the first reported case of multiple systemic venous air emboli following emergent HBOT.
• The air emboli resolved completely after a subsequent HBOT session with a longer ascent time.
• The case suggests a potential, albeit rare, complication of HBOT.

Implications:

• Physicians must be vigilant for potential complications associated with emergent HBOT.
• Decompression sickness, though rare after HBOT, warrants consideration in emergency settings.
• Awareness of this complication is crucial for patient safety during HBOT treatment.