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Air embolism. Prerogative of diving physician, medical casuistry or problem that “does not exist”?

https://doi.org/10.22328/2413-5747-2024-10-2-58-68

Abstract

OBJECTIVE. To shift the focus of practitioners’ attention to pathogenetic role of intravascular gas bubbles, which likelihood is high with wounded kidney, hollow veins and venous sinuses of the brain as well as with pressure drops, occurring in case of shockwaves, exposed to the body.


MATERIALS AND METHODS. There was analysis of literature, published from 1957 to the present and being in the public domain in the State Central Scientific Medical Library, Scientific Electronic Library “CyberLeninka”, Scientific Library of IMBP RAS, electronic databases of RSCI and PubMed. Search keywords: air embolism, mine-blast trauma. 58 articles have been analyzed.


RESULTS. Air embolism is often associated with diving medicine only. Nevertheless, there are severe (and fatal) manifestations of gas bubbles in the vascular bed in surgical practice, military medicine and clinic of internal diseases, and this cannot be ignored. Given that in blast trauma, in a number of neurosurgical, trauma operations, in anesthetic practice, in the use of AVL, and in other areas of medicine there are often situations, creating conditions for the emergence of free gas in the systemic circulation, methods of barotherapy may be demanded much more frequently than in decompression sickness. Hyperbaric physiology and diving medicine are engaged in ensuring functions of the body in a changed gaseous medium and in providing a set of measures to prevent critical states while leaving it. Also, the prerogative in this field is to use the physical properties of a changed respiratory gaseous medium under different pressure, temperature and combination of components in the treatment process.


DISCUSSION. According to the authors of the review, it is essential to work towards developing practitioners’ knowledge (especially, surgeons, anesthesiologists and resuscitators) of gas embolism and methods of barotherapy, expanding the area of surgery, anesthesiology and resuscitation, hyperbaric physiology and diving medicine to treat gas embolism of various etiologies.

About the Authors

Alexey T. Logunov
Central Design Engineering Bureau of Experimental Equipment Institute of Medico-Biological Problems of Russian Academy of Sciences
Russian Federation

General Director – Chief Designer



Igor G. Mosyagin
High command of the Navy of the Ministry of Defense of the Russian Federation
Russian Federation

Dr of Sci. (Med.), Professor, Head of the Medical Service



Alexey V. Stroy
High command of the Navy of the Ministry of Defense of the Russian Federation
Russian Federation

Inspector



Nikolay B. Pavlov
State Scientific Center of the Russian Federation – Institute of Medico-Biological Problems of Russian Academy of Sciences
Russian Federation

Сand. of Sci. (Med.), Anesthesiologist-resuscitator, Senior Researcher



Rustam R. Amirov
State Scientific Center of the Russian Federation – Institute of Medico-Biological Problems of Russian Academy of Sciences
Russian Federation

Researcher



Viktor A. Palikov
The Branch of the M. M. Shemyakin and Yu. A. Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences
Russian Federation

Senior Researcher of the Center for Biological Testing



Arkady N. Murashev
The Branch of the M. M. Shemyakin and Yu. A. Ovchinnikov Institute of Bioorganic Chemistry of the Russian Academy of Sciences
Russian Federation

Dr of Sci. (Biol.), Professor, Head of the Center for Biological Testing



Tatyana E. Kuznetsova
Pirogov Russian National Research Medical University
Russian Federation

Professor of the Department of Physiology



Viktor M. Baranov
State Scientific Center of the Russian Federation – Institute of Medico-Biological Problems of Russian Academy of Sciences
Russian Federation

Dr of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Chief Researcher, Head of the scientific direction



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Logunov A.T., Mosyagin I.G., Stroy A.V., Pavlov N.B., Amirov R.R., Palikov V.A., Murashev A.N., Kuznetsova T.E., Baranov V.M. Air embolism. Prerogative of diving physician, medical casuistry or problem that “does not exist”? Marine Medicine. 2024;10(2):58-68. (In Russ.) https://doi.org/10.22328/2413-5747-2024-10-2-58-68

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