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Monitoring of CBFV and time characteristics of oxygen‐induced acute CNS toxicity in humans
Author(s) -
Koch A. E.,
Kähler W.,
WegnerBröse H.,
Weyer D.,
KuhtzBuschbeck J.,
Deuschl G.,
Eschenfelder C. C.
Publication year - 2008
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2008.02158.x
Subject(s) - medicine , oxygen toxicity , toxicity , anesthesia , central nervous system , acute toxicity , lung
Background: Hyperbaric oxygen can cause central nervous system (CNS) toxicity with seizures. We tested the hypothesis that CNS toxicity could be predictable by cerebral blood flow velocity (CBFV) monitoring. Method: We monitored 369 mandatory oxygen tolerance tests (30 min, 280 kPa O 2 ) by video‐documentation and since May 2005 by additional CBFV registration ( n = 61). Results: The onset of early manifestations of CNS toxicity was documented in 11 of 369 tests within 22 ± 3 min. These included twitches and/or agitation, 6 of 11 and tonic–clonic seizures in 5 of 11 cases. In both cases with CBFV monitoring, an increase in CBFV preceded symptom onset, once followed by seizure, once without seizure after timely oxygen reduction. Conclusions: During exposure to 280 kPa oxygen at rest a constant delay of approximately 20 min precedes the onset of central nervous oxygen toxicity. An increase in CBFV may indicate the impending seizure.