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PubMed1984

Hyperbaric oxygen use. Update 1984.

The fact that as many as 60 new hyperbaric oxygen chambers are being established each year in the United States indicates the extent of interest in this relatively new therapy. In 1983 the Hyperbaric Medicine Committee of the Undersea Medical Society revised its classification of conditions being treated by hyperbaric oxygen (HBO), dividing them into two categories: category 1, conditions for which HBO treatment is known to be effective and is third-party reimbursable, and category 2, conditions for which such treatment is unproved experimentally or clinically and is not reimbursable. In the future many of the conditions in category 2 may be reclassified as category 1, which would allow HBO treatment to be third-party reimbursable.

Barotrauma↗
PubMed2002

Evaluation of cerebral gas retention and oedema formation in decompressed rats by using a simple gravimetric method.

OBJECTIVE: The objective of the study is twofold: first, to develop a specific gravity method for distinguishing between bubbles and oedema following decompression, and, second, to evaluate the extent to which the change in specific gravity is due to retained gas in cerebral tissue. METHODS: A brombenzene/kerosene gradient column was used to measure changes in brain specific gravity at 100 and 300 kPa, respectively. This study was performed on 23 rats. Non-exposed rats constituted the control group A (n=6). The exposed animals were divided into two groups according to the number of bubbles they developed upon decompression; group B (bubble grade 0-2, n=9) and group C (bubble grade 3-5, n=8). RESULTS: Cerebral gas retention was determined by increasing the pressure on the gradient column from 100 to 300kPa. Median specific gravity of the brain at 300kPa bar was significantly higher compared to 100 kPa for the decompressed groups B (p= 0.018) and C (p=0.012), thus implying gas retention. The cerebral gas volume was significantly higher for rats with a high bubble score compared to rats with a low bubble score (p=0.043). However, the major contribution to the change in specific gravity was due to oedema formation. CONCLUSION: The brombenzene/kerosene gradient column was found to be a sensitive method for distinguishing between gas retention and oedema formation in decompressed animals. There was a higher gas retention in rats with a high bubble score compared to rats with a low bubble score. The major contribution to the change in specific gravity in decompressed animals is due to oedema formation.

Animals↗
PubMed2000

The indigenous fisherman divers of Thailand: diving practices.

Diving practices of a group of indigenous people living on Thailand's west coast were investigated. Village chiefs were first interviewed using a questionnaire. Three hundred and forty-two active divers were then interviewed by health care workers using a second questionnaire. Field observation was used to further develop information and confirm diving practices. Divers in 6 villages, whose basic means of making a living is from diving for marine products such as fish and shellfish, have diving patterns that put them at substantial risk of decompression illness. Breathing air from a primitive compressor through approximately 100 m of air hose, these divers have long bottom times coupled with short surface intervals. Forty-six point two percent of the divers indicated that they would not make a stop during ascent from a long deep dive (40 m for 30 min). When comparing their previous day of diving to the U.S. Navy Standard Air Decompression Table (U.S. Navy, 1993), 72.1% exceeded the no-decompression limits set by the tables. Diving patterns point to a need for more in-depth research into the diving patterns of this indigenous group. Future research should include the use of dive logging devices to record depths and times. There is also a need to provide divers with information and training to reinforce positive practices and strengthen knowledge of the risks associated with their current diving practices.

Adolescent↗
PubMed2000

The indigenous fisherman divers of Thailand: diving-related mortality and morbidity.

The Urak Lawoi are indigenous fishermen on Thailand's west coast. The population includes an estimated 400 divers who dive using surface-supplied compressed air. In a cross-sectional survey conducted among the 6 major communities of Urak Lawoi, questionnaire-based interviews were administered to active divers, ex-divers, and families or colleagues of divers who had died in the previous 5 years. Six deaths resulting from diving-related accidents were identified, indicating a diving-related mortality rate of approximately 300 per 100,000 person-years, while in the same 5-year period 11 divers had been disabled owing to diving-related events, indicating a diving-related disabling event rate of approximately 550 per 100,000 person-years. Among 342 active divers interviewed, one third reported having suffered from decompression illness, although based on reported current symptoms over 50% were classified as suffering from recurring non-disabling decompression illness. Physical examination conducted on a subset of 98 active divers revealed the presence of spinal injury (clonus, raised muscle tone, and heightened reflexes) and of joint damage (pain in one or more joint, crepitus, or restricted movement) in 24 and 30% respectively. Improved primary prevention and medical treatment are needed to reduce mortality and morbidity among this population.

Accidents, Occupational↗
PubMed2006

A physiological model of the interaction between tissue bubbles and the formation of blood-borne bubbles under decompression.

Under decompression, bubbles can form in the human body, and these can be found both within the body tissues and the bloodstream. Mathematical models for the growth of both types of bubbles have previously been presented, but they have not been coupled together. This work thus explores the interaction between the growth of tissue and blood-borne bubbles under decompression, specifically looking at the extent to which they compete for the common resource of inert gas held in solution in the tissues. The influence of tissue bubbles is found to be significant for densities as low as 10 ml(-1) for tissues which are poorly perfused. However, the effects of formation of bubbles in the blood are not found until the density of bubble production sites reaches 10(6) ml(-1). From comparison of the model predictions with experimental evidence for bubbles produced in animals and man under decompression, it is concluded that the density of tissue bubbles is likely to have a significant effect on the number of bubbles produced in the blood. However, the density of nucleation sites in the blood is unlikely to be sufficiently high in humans for the formation of bubbles in the blood to have a significant impact on the growth of the bubbles in the tissue.

Blood Gas Analysis↗
PubMed1968

Diving systems.

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Decompression Sickness↗