Long-term outcome of iatrogenic gas embolism

Bessereau, Jacques, Genotelle, Nicolas, Chabbaut, Cendrine, Huon, Anne, Tabah, Alexis, Aboab, Jerome, Chevret, Sylvie and Annane, Djillali (2010) Long-term outcome of iatrogenic gas embolism. Intensive Care Medicine, 36 7: 1180-1187. doi:10.1007/s00134-010-1821-9


Author Bessereau, Jacques
Genotelle, Nicolas
Chabbaut, Cendrine
Huon, Anne
Tabah, Alexis
Aboab, Jerome
Chevret, Sylvie
Annane, Djillali
Title Long-term outcome of iatrogenic gas embolism
Journal name Intensive Care Medicine   Check publisher's open access policy
ISSN 0342-4642
1432-1238
Publication date 2010-07
Sub-type Article (original research)
DOI 10.1007/s00134-010-1821-9
Open Access Status Not yet assessed
Volume 36
Issue 7
Start page 1180
End page 1187
Total pages 8
Place of publication Heidelberg, Germany
Publisher Springer
Language eng
Formatted abstract
Objective: To establish the incidence and long-term prognosis of iatrogenic gas embolism.

Methods: This was a prospective inception cohort. We included all consecutive adults with proven iatrogenic gas embolism admitted to the sole referral academic hyperbaric center in Paris. Treatment was standardized as one hyperbaric session at 4 ATA for 15 min followed by two 45-min plateaus at 2.5 then 2 ATA. Inspired fraction of oxygen was set at 100% during the entire dive. Primary endpoint was 1-year mortality. All patients had evaluation by a neurologist, visual field tested by Goldman kinetic perimetry and brain MRI or CT scan at 6 months and 1 year.

Results: From January 1993 to August 2004, 125 of 4,727,496 hospitalizations had proven iatrogenic gas embolism. The crude mortality was 25/119 (21%) at 1 year. Cardiac arrest at time of accident and ICU admission, and SAPS II of 33 or more were independent prognostic factors of 1-year mortality (OR = 4.39, 95% CI 1.46-12.20 and OR = 6.30, 1.71-23.21, respectively). Among ICU survivors, independent predictors of 1-year mortality were age (OR = 1.07, 1.01-1.14), Babinski sign (OR = 6.58, 1.14-38.20) and acute kidney failure (OR = 8.09, 1.28-51.21). Focal motor deficits (OR = 12.78, 3.98-41.09) and Babinski sign (OR = 6.76, 2.24-20.33) on ICU admission, and duration of mechanical ventilation of 5 days or more (OR = 15.14, 2.92-78.52) were independent predictors of long-term sequels.

Conclusions: Gas embolism complicates 2.65 per 100,000 hospitalizations, and is associated with high mortality and morbidity. Babinski sign on ICU admission is associated with poor prognosis.
Keyword Gas embolism
Glasgow Outcome Scale
Iatrogenic
Mortality
Outcome
Sequels
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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