In an article in Anaesth Intensive Care. 2010 Jan;38(1):175-84, Gibson AJ, Davis FM write about patients treated at the Hyperbaric Medicine Unit, Christchurch Hospital, Christchurch, New Zealand with HBO for strokes following open heart surgery.
An Abstract of the article
Strokes remain an uncommon but significant complication of cardiac surgery. Cerebral air embolism is the likely aetiology in the majority of cases. Hyperbaric oxygen therapy is the recognised treatment for cerebral air embolism associated with compressed air (SCUBA) diving accidents and is therefore also the standard of care for iatrogenic causes of air embolism. It follows that there is a logic in treating post-cardiac surgical stroke patients with hyperbaric oxygen. The aim of this retrospective review was to examine the outcomes of 12 such patients treated in the Christchurch Hospital hyperbaric unit and to appraise the evidence base for the use of hyperbaric oxygen therapy in this setting. Despite delays of up to 48 hours following surgery before the institution of hyperbaric oxygen therapy, 10 of the 12 patients made a full neurological recovery or were left with mild residual symptoms, with nine returning to their previous level of care. One patient remained hemiplegic and there was one early neurological death. There is a paucity of prospective data in this area, but based on sound pathophysiological principles and clinical experience, we believe that patients suffering a stroke following open cardiac surgery should be considered for hyperbaric oxygen therapy.
Related Citations:
- Aortic and mitral valve surgery on the beating heart is lowering cardiopulmonary bypass and aortic cross clamp time. [Heart Surg Forum. 2002]
- [Hyperbaric oxygenation in cerebral air embolism occurring during open-heart surgery (author's transl)] [G Ital Cardiol. 1981]
- Safety of minimally invasive mitral valve surgery without aortic cross-clamp. [Ann Thorac Surg. 2008]
Safety of minimally invasive mitral valve surgery without aortic cross-clamp.Umakanthan R, Leacche M, Petracek MR, Kumar S, Solenkova NV, Kaiser CA, Greelish JP, Balaguer JM, Ahmad RM, Ball SK, et al. Ann Thorac Surg. 2008 May; 85(5):1544-9; discussion 1549-50.
- Review Abdominal complications following open-heart surgery: a report of 12 cases and review of the literature. [Acta Cardiol. 2006]
Review Abdominal complications following open-heart surgery: a report of 12 cases and review of the literature.Kurt M, Litmathe J, Roehrborn A, Feindt P, Boeken U, Gams E. Acta Cardiol. 2006 Jun; 61(3):301-6.
- Review Operative outcome of simultaneous carotid and valvular surgery. [Ann Thorac Surg. 2004]
