Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DECOMPRESSION SICKNESS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 955 records · Page 53Linked to original sources
PubMed1989

[Recompression therapy in diving accidents--introduction, indication].

We show that among the numerous complications which may arise during diving, two have to be considered very carefully, namely decompression sickness and arterial gas embolism, for if treatment is being done inadequately, these may lead to permanent disability. Diagnosis and treatment are described. In general, therapy is given in a hyperbaric chamber by pure oxygen, in a hospital with the relevant equipment. Nevertheless, it is of prime importance to give, already on the scene of the diving emergency, as soon as possible pure normobaric oxygen as respiratory gas.

Accidents↗
PubMed1985

Increase of plasma renin activity in male and female rabbits subjected to dysbaric conditions.

The renin-angiotensin-aldosterone system may be implicated in hemodynamic alterations occurring in dysbaric disorders. This report concerns changes in plasma renin activity (PRA) induced by exposure of rabbits to a compression-decompression schedule that does not normally produce clinical manifestations of decompression sickness (DS). The results revealed a significant increase in PRA in 19 of 23 animals following dysbaric exposure. Mean PRA rose from 1.18 ng Angl X ml-1 X hr-1 (preexposure) to 2.40 ng Angl X ml-1 X hr-1 (postexposure). The increase was particularly pronounced in female animals (217%). Asymptomatic intravascular gas bubbles ("silent bubbles") were detected by gross or microscopic examination in the majority of the animals. Renin elaboration and secretion in asymptomatic dysbaric exposures may be mediated by bradykinin and/or prostaglandins released or activated in a chain reaction triggered by silent gas bubbles. This hypothesis is also applicable to increased PRA in altitude decompression. Alternatively elevation of PRA may result from decreased renal perfusion when dysbaric disorders are complicated by significant hypovolemia.

Animals↗
PubMed1976

Intravascular bubbles associated with intravenous injections and altitude.

Ultrasonically detected microbubbles were more abundant in the pulmonary artery of dogs intravenously injected with 10 ml of saline than in the same noninjected controls during 10,000 ft (3,048 m), 20,000 ft (6,096 m), and 40,000 ft (12,192 m) exposures. Continuous intravenous (i.v.) drip infusions also introduced many small bubbles. Since they may serve as "nuclei" for visible intravascular bubble formation, are sometimes associated with decompression sickness, and are additionally considered undesirable, it would appear prudent to minimize i.v. injections immediately before flights. However, a 10-min delay before ascent will reduce their number and a 60-min delay will insure their almost complete absence. Also, slow ascent, a 1-h denitrogenation time, or use of a degassed solution will help reduce their total number.

Aerospace Medicine↗
PubMed1997

[Evaluation of the risk of decompression disease during hypobaric decompression from the standpoint of the probability theory].

Author's probabilistic theory of decompression sickness (DS) asserts that DS risk for human subjects during a single-stage reduction of pressure will be rated by distribution of estimated nucleation efficiency in the "worst" body tissues and its critical value as a function of initial nitrogen pressure, end-pressure, and bubble growth dynamics. The method was tested in the analysis of literature on the DS risk during altitude exposures with preliminary denitrogenation of varying length. Results of the analysis suggest that washing out half of nitrogen from the "worst" tissues will take minimum 480 minutes instead of 360 minutes. Calculated parameters of nucleation in tissues were used to plot DS risk due to hypobaric decompression against the final pressure. Influence of physical activity on nucleation parameters and DS risk curves is discussed.

Decompression↗
PubMedDate not supplied

Helium-oxygen therapy in the emergency department.

Helium is an inert gas with unique physical properties that allow it to be used for various respiratory emergencies. Because of its low specific gravity and low viscosity, the passage of helium through the respiratory tract is smoother, more laminar, and less turbulent than either air or oxygen. These properties have prompted the use of helium and oxygen in patients with airway obstructions due to tumor, foreign body, edema, or bronchoconstriction. Helium-oxygen has been used to facilitate bronchoscopy through small diameter endotracheal tubes and to increase the effectiveness of high-frequency jet ventilation. Helium has been successful in the treatment of spinal cord decompression sickness seen in divers. Helium-oxygen mixtures are commercially available and may be useful in the emergency department to treat patients with airway obstruction. This article reviews literature concerning the use of helium-oxygen gas mixtures in the emergency department. Additional research conducted in the future may further define the use of this unique gas mixture in the emergency department.

Airway Obstruction↗
PubMed1997

[Retinal vein occlusion and deep-sea diving].

We report a case of retinal vein occlusion after breath-holding diving. After one hour of diving at a maximal depth of eight meters, each apnea no longer than one minute, the patient complained of a diminution of the visual acuity in the left eye. Ophthalmological examination revealed an occlusion of the superior branch of the central vein of the retina in the left eye. This could be considered as a decompression sickness even if the occlusion could happen fortuitously in water. Secondary to the multiple descents, a bubble would have appeared in the vein leading to an obstruction. The purpose of this paper is to discuss a possible link between the breath-holding diving and this kind of accident. We also report the different ophthalmological features that may occur while diving.

Decompression Sickness↗
PubMedDate not supplied

A new preoxygenation procedure for extravehicular activity (EVA).

A 10.2 psi staged-decompression schedule or a 4-hour preoxygenation at 14.7 psi is required prior to extravehicular activity (EVA) to reduce decompression sickness (DCS) risk. Results of recent research at the Air Force Research Laboratory (AFRL) showed that a 1-hour resting preoxygenation followed by a 4-hour, 4.3 psi exposure resulted in 77% DCS risk (N=26), while the same profile beginning with 10 min of exercise at 75% of VO2peak during preoxygenation reduced the DCS risk to 42% (P<.03; N=26). A 4-hour preoxygenation without exercise followed by the 4.3 psi exposure resulted in 47% DCS risk (N=30). The 1-hour preoxygenation with exercise and the 4-hour preoxygenation without exercise results were not significantly different. Elimination of either 3 hours of preoxygenation or 12 hours of staged-decompression are compelling reasons to consider incorporation of exercise-enhanced preoxygenation.

Aerospace Medicine↗
PubMed1984

Remote monitoring of neuraxial function in anesthetized dogs in compression chambers.

This paper describes the development of an electrophysiological model using spinal and cortical evoked potentials (SEP, CEP), for the diagnosis and monitoring of spinal cord decompression sickness (DCS) in anesthetized dogs. A comparison of alpha-chloralose with sodium pentobarbital showed that the latter caused a reduction in CEP amplitude. Continuous observation of EPs over 5 h showed a small reduction and an increasing variance of amplitude with time. The effectiveness of the method in the diagnosis of DCS and in studies of the adequacy of treatment is illustrated with several examples.

Anesthesia↗
PubMed1997

Dysbaric osteonecrosis in divers and caisson workers. An animal model.

Dysbaric osteonecrosis was induced successfully in adult sheep after 12 to 13, 24-hour exposures to compressed air (2.6-2.9 atmospheres absolute) during a 2-month period. All exposed sheep had decompression sickness and extensive bone and marrow necrosis in their long bones. Radiographic analysis of these progressive lesions showed mottled to distinct medullary opacities and endosteal thickening characteristic of dysbaric osteonecrosis. Six months after the last hyperbaric exposure, neovascularization of once ischemic fatty marrow was centripetal from the diaphyseal cortex. Proliferating endosteal new bone, fatty marrow calcification, and appositional new bone formation were widespread. Juxtaarticular osteonecrosis involved marrow fibrosis and loss of osteocytes in subchondral cortical bone. Tidemark reduplication in juxtaarticular bone and cartilage thinning suggested possible early osteoarthritis induction by recurrent episodes of transient ischemia after multiple hyperbaric exposures. Dysbaric osteonecrosis appears to involve a bone compartment syndrome of elevated intramedullary pressure initiated by decompression induced N2 bubble formation in the fatty marrow of the long bones. An animal model that can be used to investigate the pathogenesis, diagnosis, and treatment of dysbaric osteonecrosis is discussed.

Animals↗
PubMed2005

Fatal scuba diving incident with massive gas embolism in cerebral and spinal arteries.

CT and MRI have the potential to become useful adjuncts to forensic autopsy in the near future. The examination of fatal injuries facilitates a profound experience in the clinical-radiological examination of these cases; the more severe findings in corpses with autopsy verification can help one to understand the tiny signs seen in clinical cases of surviving victims. We present the case of a 44-year-old male diver who died from severe decompression sickness after rapid ascent from approximately 120 m. Post-mortem CT and MRI studies of the brain and spinal cord revealed extensive gas inclusions in cerebral arteries, spinal arteries and cerebrospinal fluid (CSF) spaces, while the intracranial venous sinuses remained unaffected. These findings were confirmed at autopsy. Appropriate imaging techniques can help forensic pathologists to aim their autopsies at findings that might otherwise remain undetected.

Adult↗
PubMed1977

Scuba diving deaths: a review and approach for the pathologist.

A series of 34 cases of SCUBA-related fatalities in military personnel from the files of the Armed Forces Institute of Pathology has been presented. It may be concluded that the potential problems that can occur in the hyperbaric aquatic milieu while using scuba are not completely appreciated by pathologists. The resulting investigations of such fatalities give little hard data relevant to such entities as true incidence of barotraumatic injuries, aseptic bone necrosis, and contaminated air supply, the interrelationship of human, environmental, and life support system factors in such fatalities, and the pathophysiologic sequences leading to drowning or death due to causes other than drowning. Hyperbaric pathophysiology is reviewed with the hope that more reasonable interpretations of cause and mechanisms of death will be possible, and the entities air embolism and decompression sickness are differentiated in a similar light. The importance of the type of SCUBA is discussed, through analysis of ten operational diving fatalities, and the possibility of anoxia, hyperoxic convulsions, and hypercapnia existing with the use of rebreather SCUBA is emphasized. A general approach to the medical investigation of a SCUBA fatality is given, under broad headings including on-the-scene investigation, clothing and equipment examination, external and internal examinations, and toxicologic examination.

Adult↗
PubMed1982

Survival following accidental decompression to an altitude greater than 74,000 feet (22,555 m).

A man was accidentally decompressed to an altitude greater than 22,555 m (74,000 ft) in an industrial vacuum chamber. He experienced burst lung, massive decompression sickness, and sustained ebulism. He remained at altitude for a period of 3-5 min. By 5.5 h following the accident, he was still profoundly unconscious. He was subsequently treated in a hyperbaric chamber with recompression on a modified U.S. Navy Table 6A and had eventual clinical recovery. The CPK peaked at 8000 units 2 d after the accident, demonstrating substantial barotrauma to the tissues.

Accidents, Occupational↗
PubMed1977

Bubble formation within decompressed hen's eggs.

Decompression sickness follows a reduction in ambient pressure and is a result of bubble formation in blood or tissues. The origin of such bubbles is the subject of considerable controversy, and a number of mechanisms have been proposed to account for them. In testing these mechanisms, freshly-laid hen's eggs provide a particularly intriguing model--namely, an intact biological system in which bubbles form readily and many of the proposed processes are excluded.

Animals↗
PubMed1982

Fetal development: effects of stimulated diving and hyperbaric oxygen treatment.

Fetuses from hamsters exposed to repetitive 5.2-ATA (140 fsw) air dives during early pregnancy showed no significant differences from the control group in birth weight, frequency of malformation, or death. Also, exposure of mothers to hyperbaric oxygen as required for treatment of decompression sickness (DCS) has no adverse effect on fetal development or survival. Although the number of females who suffered and survived DCS in this study was small (n = 3), teratogenic effects were nevertheless found among the fetuses of this group. In fact, at least one fetus from each female undergoing DCS was found to have serious malformations. These results suggest that DCS during early organogenesis may have significant deleterious effects on fetal development.

Animals↗
PubMed1977

Roentgenographic search for avascular necrosis of the head of the femur in alcoholics and normal adults.

Roentgenograms of 1,410 hips from 705 alcoholics were compared with those of 200 hips from 100 controls for changes consistent with non-traumatic (idiopathic) necrosis of the femoral head according to the findings diagnostic of necrosis of bone that were outlined by the Decompression Sickness Panel of the British Medical Research Council. Abnormalities were found in 45.3 per cent of the alcoholics and 49 per cent of the controls. None of the findings showed any statistical difference between the controls and the alcoholics. It was concluded that the roentgenographic findings used were not valid in detecting the early or subtle changes of necrosis of the femoral head and that the changes found in both groups are common and probably non-specific.

Adult↗
PubMed1987

Women and the hazardous environment: when the pregnant patient requires hyperbaric oxygen therapy.

Women are now being exposed in increasing numbers to environmental hazards. Normal operations in that environment plus accidents or training procedures may result in conditions such as decompression sickness, air embolus, hyperoxia, or carbon monoxide poisoning occurring in a woman who also happens to be pregnant. This article examines the animal data and human experience in these conditions in both early and late gestation. The risk of these conditions to the mother and fetus is assessed compared to the problems associated with hyperbaric oxygen therapy (HBO) in pregnancy. Suggestions are made regarding the appropriate use of HBO therapy in pregnancy. Further medical investigation is requested.

Aerospace Medicine↗
PubMed1999

Diving and marine medicine review part II: diving diseases.

Diving is a high-risk sport. There are approximately between 1 to 3 million recreational scuba divers in the USA (with over a quarter-million learning scuba annually); there are about 1 million in Europe and over 50,000 in the United Kingdom. In this population 3-9 deaths/100,000 occur annually in the US alone, and those surviving diving injuries far exceeds this. Diving morbidity can be from near-drowning, from gas bubbles, from barotrauma or from environmental hazards. In reality, the most common cause of death in divers is drowning (60%), followed by pulmonary-related illnesses. The mean number of annual diving fatalities in the USA from 1970 to 1993 was 103.5 (sd 24.0) and the median was 106. This article will focus primarily upon pressure effects on the health of a diver. There are two principle ways pressure can affect us: by direct mechanical effects and by changing the partial pressures of inspired gases. Dysbarism is a general term used to describe pathology from altered environmental pressure, and has two main forms: barotrauma from the uncontrolled expansion of gas within gas-filled body compartments and decompression sickness from too rapid a return to atmospheric pressure after breathing air under increased pressures. Greater than 90% of the human body is either water or bone, which is incompressible; the areas directly affected by pressure changes thus are those that are filled with air or gas. These sites include the middle ear, the eustachian tube, the sinuses, the thorax, and the gastrointestinal tract. Air in these cavities is compressed when the ambient pressure rises because the pressure of inhaled air must equilibrate with the ambient pressure.

Decompression Sickness↗
PubMed2003

Experienced scuba divers in Australia and the United States suffer considerable injury and morbidity.

OBJECTIVE: Scuba diving-specific injuries have been well described. However, the injury experiences of individual divers over long diving careers have rarely been investigated. Our objective was to study the acute and chronic injuries of experienced, recreational scuba divers. METHODS: This was an international, cross-sectional, descriptive postal survey of experienced, recreational scuba divers belonging to diving clubs in Australia and the United States. RESULTS: Seven hundred nine divers were enrolled (346 Australian divers and 363 US divers). Most participants were experienced (mean number of dives, 262) male divers (488; 68.8%) aged 31 to 50 years (425; 59.9%). Mild barotrauma was common. Ear, sinus, and tooth "squeeze" had been experienced on > or = 1 occasion by 369 (52.1%), 245 (34.6%), and 66 (9.2%) divers, respectively. Tympanic membrane (TM) rupture, round/oval window rupture, and subcutaneous emphysema had been experienced by 38 (5.4%), 8 (1.1%), and 5 (0.7%) divers, respectively. No diver reported pneumothorax or arterial gas embolism (AGE); however, 31 divers (4.4%) had suffered decompression sickness (DCS). A wide range of other injuries were reported. Sixteen divers (2.3%) reported permanent disabilities, which largely consisted of hearing loss, tinnitus, and balance disorder. CONCLUSIONS: The majority of experienced divers who responded to the survey had suffered diving-related injuries, mainly barotrauma. Further research and diver education are needed to better document injury rates and minimize serious diving-related injuries and permanent disabilities.

Accidents↗