Successful therapy of cerebral air embolism with hyperbaric oxygen at 2.8 ATA

A 60-year-old male patient suddenly developed blindness, agitation, and disorientation 36 h after coronary bypass surgery. Onset of symptoms followed efforts to clear an air-filled radial artery cannula. Seven hours after onset of symptoms, initial compression to 2.8 ATA (60 fsw), 100% oxygen (U.S. Navy Table 6), steroids, intravenous fluids, and antiplatelet drugs were used for therapy. The patient's agitation and disorientation dictated that we avoid initial compression to 6 ATA (165 fsw), contrary to conventional practice in therapy of air embolism, and instead immediately give oxygen at 2.8 ATA. After a second treatment with USN Table 6, given 6 h after the first, the patient's vision and mental state returned to normal. He subsequently had an uneventful recovery from surgery and cerebral air embolism.