PubMed · 13093161
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1953. [Caisson disease].. https://pubmed.ncbi.nlm.nih.gov/13093161/
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Recompression and oxygen breathing constitute the primary treatments for decompression sickness (DCS). Increasing the volume of distribution of dissolved gas with high-volume liquid therapy represents an alternative strategy to prevent or treat DCS. Furthermore, degassing of ingested and infused liquids would increase their potential to keep supersaturated tissue gases in solution after decompression. We hypothesize that administration of degassed liquids will prevent or reverse mild-moderate DCS by increasing the volume of distribution of dissolved gas in DCS victims. Degassed perfluorocarbon ingestion offers particularly attractive potential: one liter theoretically dissolves approximately 300ml of N(2) in vivo at 1atm. One could speculate that degassed liquids may adequately treat mild DCS in lieu of recompression, particularly DCS expressed in 'fast compartment' (well-perfused) tissues. Furthermore, degassed liquid administration should prove to be even more effective adjunct therapy for severe DCS than present gas-saturated liquids.
OBJECTIVES/HYPOTHESIS: Inner ear decompression illness is thought to be a rare phenomenon in recreational divers, isolated signs and symptoms of inner ear dysfunction usually being attributed to inner ear barotrauma. STUDY DESIGN: We present 11 cases of inner ear dysfunction in nine divers with inner ear decompression illness. RESULTS: All nine divers had significant right-to-left shunt as diagnosed by transcranial Doppler sonography. CONCLUSIONS: The authors thought that mechanism of causation in these cases may have been intravascular bubble emboli and that inner ear decompression illness may be more common among recreational divers than currently recognized. Failure to treat inner ear decompression illness with recompression therapy can result in permanent disability. Because the differential diagnosis between inner ear barotrauma and inner ear decompression illness can be impossible, the authors suggested that divers who present with inner ear symptoms following a dive should have recompression immediately after having undergone bilateral paracentesis.