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- W2079694498 abstract "We present a 29-year-old man with cerebral arterial gas embolism (CAGE) due to barotrauma sustained during extubation. The patient, who had a history of bipolar disorder and smoking, had been admitted for an open pyeloplasty, performed for ureteric obstruction. This was complicated by post-operative haemorrhage requiring further surgery and intensive care admission. Three days later he was alert and following commands. Intubation had been difficult (Grade 2–3 Cormack–Lehane laryngoscopic assessment); therefore, a Cook airway exchange catheter, which allows oxygen to be administered during potentially difficult extubation or re-intubation (Fig. 1), was used as a precaution. It was passed 35 cm beyond the endotracheal tube (ETT). During extubation the patient became pale and diaphoretic, his teeth clenched around the Cook catheter and airway protection was compromised. Oxygen (8–10 L/min) and propofol were administered and rapid re-intubation was achieved by “rail-roading” the ETT over the Cook catheter. There was bradycardia and hypotension for about 15 s and the event lasted 2.5 min in total. Cardiopulmonary resuscitation was briefly performed although oxygen saturation remained >95%. Post-intubation chest X-ray revealed subcutaneous and mediastinal emphysema and bilateral pneumothoraces were subsequently identified on a chest CT scan. Several hours after the event, despite no further sedation and empirical administration of flumazenil and naloxone, the patient remained comatose." @default.
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- W2079694498 date "2009-02-01" @default.
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- W2079694498 title "Coma and seizures due to gas emboli following extubation" @default.
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- W2079694498 doi "https://doi.org/10.1016/j.jocn.2007.11.013" @default.
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