Haemoconcentration in Neurological Decompression Illness

Boussuges, Alain; Blanc, P.; Molénat, Françoise; Bergmann, E.; Sainty, J. M.

doi:10.1055/s-2007-972859

Cited by 47 publications

(30 citation statements)

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“…As haemoconcentration leads to an increase in blood viscosity [295,308], normovolemia should be achieved to optimise the microcirculation and to reduce neurological damage [309]. Colloid solutions are preferable because crystalloid solutions may promote cerebral oedema.…”

Section: Treatmentmentioning

confidence: 99%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

Eur Respir J

162

127

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Nonthrombotic pulmonary embolism (NTPE) is defined as embolisation to the pulmonary circulation of different cell types (adipocytes, haematopoietic, amniotic, trophoblastic or tumour), bacteria, fungi, foreign material or gas. The purpose of this article is to describe the clinical signs, pathogenesis, diagnosis and treatment of the different NTPE subtypes.The complex and diverse pathogenesis of different subtypes of emboli is subject to continuing speculation and is certainly far more complex than ''simple'' mechanical obstruction after embolisation of vascular thrombi. Nonthrombotic emboli may also lead to a severe inflammatory reaction both in the systemic and pulmonary circulation, as well as in the lung.NTPE presents a formidable diagnostic challenge, as the condition often presents with very unusual and peculiar clinical signs that are frequently overlooked. They range from very dramatic acute presentations such as acute respiratory distress syndrome to signs observed late in the disease course. Pathological observations play a key role in the exact diagnosis, and sometimes carefully aspirated blood from the pulmonary artery or specific staining of cells recovered from bronchoalveolar lavage fluid may be helpful. Frequently, lung biopsies revealing severe granulomatous reaction or unfortunate post-mortem pathological investigations of pulmonary tissue are necessary to confirm the diagnosis. Here, we also aim to familiarise the reader with the atypical radiological features of NTPE. Thin-section computed tomography of the lungs showing peculiar radiographic findings, such as a feeding vessel, the so-called tree-in-bud pattern or the appearance of micronodules distributed at the termination of bronchovascular bundles, may be observed in certain forms of NTPE.Increased awareness of NTPE as an underestimated cause of acute and chronic embolism, which may result in acute and chronic pulmonary hypertension, is needed. Despite the fact that detailed descriptions of several forms of NTPE have existed for nearly 100 years, well-designed trials have never been performed to evaluate therapy in the different subsets of these patients.

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Section: Treatmentmentioning

confidence: 99%

Nonthrombotic pulmonary embolism

Jorens¹,

Marck²,

Snoeckx³

et al. 2009

Eur Respir J

162

127

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“…Interaction with endothelial membranes causes increased capillary permeability and extravasation of fluid. This can cause shock, pulmonary edema, and organ failure, especially in the brain [32,33]. In our series of over two thousand cases we have never seen gas embolism, at least not in a clinically apparent magnitude.…”

Section: Venous Gas Embolismmentioning

confidence: 56%

A brief review: anesthesia for robotic prostatectomy

Baltayian

2008

J Robotic Surg

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“…In addition, fluid resuscitation is useful to counteract haemoconcentration and dehydration [13]. Divers are prone to dehydration because of fluid loss through respiration and increased diuresis during the scuba dive, due to an increase in intrathoracic blood volume, induced by the immersion.…”

Section: Emergency Treatmentmentioning

confidence: 99%

Hyperbaric emergencies and decompression illness

Muth¹,

Radermacher²

2015

Réanimation

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Decompression illness (DCI) is the most important emergency resulting from exposure to hyperbaric environments. Immediate diagnosis and management mostly allow for complete recovery without sequelae. Emergency and critical care physicians need to be aware of the possible symptoms, since there are no DCI-specific symptoms, and the clinical presentation can simulate a variety of other pathologies. Initial treatment of choice is the administration of pure oxygen together with adjunctive measures such as fluid expansion and eventually symptomatic medication, followed by hyperbaric oxygen (HBO) treatment. Patient management under hyperbaric conditions requires taking into account the physics of hyperbarism to avoid any procedure-related pitfalls.

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Haemoconcentration in Neurological Decompression Illness

Cited by 47 publications

References 0 publications

Nonthrombotic pulmonary embolism

Nonthrombotic pulmonary embolism

A brief review: anesthesia for robotic prostatectomy

Hyperbaric emergencies and decompression illness

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