CAGE and pneumothorax?

[TheAvatar]

Is an arterial gas embolism usually accompanied by pneumothorax?

Can an arterial gas embolism be caused by something besides pulmonary barotrauma (or air in an injection)?

 

[TwoBitTxn]

Is an arterial gas embolism usually accompanied by pneumothorax?

I wouldn't think it would be. I am guessing you know the definition of a pneumothorax. I would believe you need more than a small handfull of alveoli rupturing to cause a measurable pneumo.

Can an arterial gas embolism be caused by something besides pulmonary barotrauma (or air in an injection)?

Yes, PFO will do it.

TwoBit

 

[Wildcard]

If there is a defect or injury to the plural lining and an over pressure injury occures, maybe, but not a good chance.

 

[vjongene]

Is an arterial gas embolism usually accompanied by pneumothorax?

AFAIK, the two are unrelated. A pneumothorax happens when the pleural membranes are ruptured, causing the lung to peel away from the thoracic cavity. An AGE happens when the alveoli rupture, injecting air into the pulmonary vein and hence into the left side of the heart and the arterial circulation. Both can be caused by a pulmonary barotrauma, but one does not necessarily imply the other.

Can an arterial gas embolism be caused by something besides pulmonary barotrauma (or air in an injection)?

As already said by TwoBitTxn, a PFO can do it too, but only in case where there is already serious DCS. In most diving situations, AGE will in fact be caused by pulmonary barotrauma.

Disclaimer: I am not a doctor, and my knowledge was derived from reading books, not treating patients. This is not medical advice.

HTH,

Victor J.

 

[DocVikingo]

RE your statement "... and my knowledge was derived from reading books...."

Where did you read that "...a PFO can do it too, but only in case where there is already serious DCS?"

Thanks,

DocVikingo

 

[vjongene]

RE your statement "... and my knowledge was derived from reading books...."

Where did you read that "...a PFO can do it too, but only in case where there is already serious DCS?"

This was only by deduction, not quoted from a book. If there is a serious case of DCS, bubbles present in the venous circulation will cross over into the arterial circulation through the PFO, thus causing an AGE. This makes sense to me, but may not be obseved in clinical practice. Sorry for the imprecision.

 

[Saturation]

This was only by deduction, not quoted from a book. If there is a serious case of DCS, bubbles present in the venous circulation will cross over into the arterial circulation through the PFO, thus causing an AGE. This makes sense to me, but may not be obseved in clinical practice. Sorry for the imprecision.

Yes, that indeed is a serious cause of AGE or DCS 2 or neurologic bends.

 

[Saturation]

Is an arterial gas embolism usually accompanied by pneumothorax?

Can an arterial gas embolism be caused by something besides pulmonary barotrauma (or air in an injection)?

AGE can occur when a large amount of bubbles enters the arterial circulation, lodges and blocks circulation to the brain. This can happen when a large load of bubbles form from inadequate decompression and the volume overloads the lungs, causing it to leak through the lungs, in divers with no PFO. In divers with PFOs or other lungs or heart shunts, the bubbles traverse the shunt into arterial circulation.

During a pneumothorax, inhaled gas leaks into circulation via a break in the lung linings and can cause AGE. In normal lungs gas and blood do not mix, they are separated by a gas permeable membrane, with the whole lung wrapped in an air tight sheath. Either the sheath or the membrane ruptures and cause the gas leaks.

 

[DocVikingo]

Yes, that indeed is a serious cause of AGE or DCS 2 or neurologic bends.

Yes, PFO indeed is a serious cause of AGE or Type II DCS 2/neurologic bends. However, I do not believe that it is necessary to manifest an "already serious DCS," PFO-related or otherwise, in order for AGE to develop.

 

[Saturation]

Yes, PFO indeed is a serious cause of AGE or Type II DCS 2/neurologic bends. However, I do not believe that it is necessary to manifest an "already serious DCS," PFO-related or otherwise, in order for AGE to develop.

Agree fully, without overt DCS AGE can appear from a tolerable bubble load that transits the PFO, other shunts or even de novo bubbles.