[Gas embolism during protective ventilation for acute respiratory distress syndrome].
A 34-year-old woman with toxic coma developed inhalation pneumonia complicated by the acute respiratory distress syndrome. Marked parenchymal destruction and recurrent pneumothorax occurred despite protective ventilation. Altered consciousness persisted after sedative withdrawal, and the patient subsequently died. Computed tomography revealed multiple cerebral, renal and splenic infarcts. The only identified cause of systemic embolism was multiple gas embolisms. We discuss the physiopathological mechanisms, and the diagnostic and therapeutic management of such patients.
Desachy
A
A
Service de réanimation polyvalente, centre hospitalier d'Angoulême, Saint-Michel, France. arnaud.desachy@ch-angouleme.rss.fr
Gissot
V
V
D000328:Adult; D003128:Coma / Q000139:chemically induced / Q000628:therapy; D004618:Embolism, Air / Q000209:etiology* / Q000503:physiopathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D011014:Pneumonia / Q000139:chemically induced / Q000628:therapy; D011030:Pneumothorax / Q000209:etiology; D012008:Recurrence; D012121:Respiration, Artificial / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000150:complications* / Q000628:therapy*; D014057:Tomography, X-Ray Computed