A review of the pathophysiology and potential application of experimental therapies for cerebral ischemia to the treatment of cerebral arterial gas embolism.
This review considers the pathophysiology of air embolism that occurs as a result of diving and iatrogenic accidents. Various experimental therapies are classified according to their potential mechanism of action. The effectiveness and prospects for application to the clinical situation are assessed for each therapy. Hyperbaric oxygen remains the most effective therapy, and it is one that is simple to apply. The physiologic changes that occur after gas embolism are complex, however, and future improvements in therapy will demand close clinical supervision and multiple individually tailored therapeutic decisions rather than a simple protocol.
D000818:Animals; D001469:Barotrauma / Q000503:physiopathology; D001809:Blood Viscosity / Q000187:drug effects; D001812:Blood-Brain Barrier / Q000187:drug effects; D001921:Brain / Q000503:physiopathology; D002545:Brain Ischemia / Q000188:drug therapy / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects; D004242:Diving; D004618:Embolism, Air / Q000188:drug therapy / Q000503:physiopathology*; D004734:Energy Metabolism / Q000187:drug effects; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000503:physiopathology; D007427:Intracranial Pressure / Q000187:drug effects; D055370:Lung Injury; D009474:Neurons / Q000502:physiology