Recommendations for Hyperbaric Oxygen Therapy of Cerebral Air Embolism Based on a Mathematical Model of Bubble Absorption

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Abstract
Ed a mathematical model to predict the absorption time of CAAE, assuming that the volumes of clinically relevant CAAE vary from 10-7 to at least 10-1 mL. Absorption times are predicted to be at least 40 h during oxygenation using breathing gas mixtures of fraction of inspired oxygen approximately equal to 40%. When CAAE are large enough to be detected by computerized tomography, absorption times are calculated to be at least 15 h. Decreases in cerebral blood flow caused by the CAAE would make the absorption even slower. Our analysis suggests that if the diagnosis of massive CAAE is suspected, computerized tomography should be performed, and consideration should be given to HBO therapy if the CAAE are large enough to be visualized, even if patient transfer to a HBO facility will require several hours. (Anesth Analg 1997;84:1203-7)...