Diving and hyperbaric medicine最新文献

{"title":"Effect of a prior hypercapnia experience on recognition of hypercapnia in divers: a randomised controlled study.","authors":"Thalia Babbage, Hanna van Waart, Charlotte Jw Connell, Nicholas Gant, Simon J Mitchell, Xavier Ce Vrijdag","doi":"10.28920/dhm56.2.115-124","DOIUrl":"10.28920/dhm56.2.115-124","url":null,"abstract":"<p><strong>Introduction: </strong>Rebreather diving carries an increased risk of hypercapnia. Hypercapnia can cause impaired cognition, breathlessness, and increase the risk of oxygen toxicity. We investigated whether a prior unblinded hypercapnia experience, compared to reading about hypercapnia symptoms, would improve divers' ability to recognise hypercapnia and initiate self-rescue.</p><p><strong>Methods: </strong>Forty divers were recruited and randomised to receive either an unblinded hypercapnia experience (partial pressure of end-tidal carbon dioxide [P_ETCO₂] of 8.5 kPa) or an information leaflet explaining hypercapnia symptoms. At least one month later, participants in each group were further randomised to undergo blinded exposure to hypercapnia or normocapnia, allocated at 3:1. The primary outcome was the proportion of participants who self-initiated bailout prior to reaching P_ETCO₂ 8.5 kPa. Continuous cardiorespiratory data (P_ETCO₂ and P_ETO₂, tidal volume, respiratory rate, minute ventilation, heart rate, and blood pressure) were also recorded. Subjective symptoms associated with hypercapnia were assessed with a visual analogue scale.</p><p><strong>Results: </strong>Thirteen of 15 participants (87%) who received the unblinded hypercapnia-experience self-initiated bailout compared to 10/15 information leaflet participants (67%) (P = 0.149). There was no difference in cardiorespiratory physiology parameters at bailout between the groups. Shortness of breath, light-headedness, and disorientation were the most intensely reported symptoms. Approximately half (47%) of participants who received a hypercapnia training experience had a correlated symptom response during their subsequent hypercapnia testing session.</p><p><strong>Conclusions: </strong>Although no significant training benefit was shown, becoming familiar with the sensations associated with hypercapnia under appropriate supervision could be useful to rebreather divers both recreationally and within occupational settings.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 2","pages":"115-124"},"PeriodicalIF":1.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technical diving accidents in France: a 15-year retrospective study reporting a high prevalence of musculoskeletal decompression sickness.","authors":"Emmanuel Gouin, Anaïs Caillard, Colin Veses, Marc Luciani, Charlotte Lecomte, Emmanuel Dugrenot, François Guerrero, Jean-Éric Blatteau","doi":"10.28920/dhm56.2.125-136","DOIUrl":"10.28920/dhm56.2.125-136","url":null,"abstract":"<p><strong>Introduction: </strong>Technical diving, involving rebreathers and/or helium-based gas mixtures for deeper and longer dives, may influence risk and clinical presentation of injuries due to helium's properties, equipment constraints, or exposure conditions. This study aims to describe the specific characteristics of this accidentology.</p><p><strong>Methods: </strong>A retrospective study was conducted across five French coastline hyperbaric units. Medical records of technical divers presenting with decompression sickness (DCS), immersion pulmonary oedema (IPO), or gas-toxicity between 2010 and 2024 were reviewed.</p><p><strong>Results: </strong>127 technical divers were included, three declined participation, leaving 124 cases for analysis. DCS was the most frequent condition (n = 105) followed by IPO (n = 16) and gas toxicity (n = 3). Median age was 45 [IQR 37-53] years, and 113 (91%) were male. Rebreathers were used in 94 (75.8%) cases and helium-based mixtures in 77 (62%). Previous diving-related accidents were reported in 36 (29%) cases. IPO occurred mainly after shallower dives in wetsuits and was frequently associated with procedural errors. Among DCS cases isolated musculoskeletal DCS predominated (n = 36), whereas spinal involvement was less frequent. When indicated, median recompression delay was 238 [IQR 135-555] minutes. Unfavourable outcomes occurred in 26 (25%) DCS cases, primarily with bone or inner-ear involvement.</p><p><strong>Conclusions: </strong>Technical diving accidents exhibit distinct patterns from recreational diving, notably greater musculoskeletal involvement and a possible increased risk of dysbaric osteonecrosis (DON). Current evidence does not support different management, but the risk of potential initially silent bone lesions should not be overlooked. Further research on helium-related risks and hyperbaric treatment's role in DON prevention is needed.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 2","pages":"125-136"},"PeriodicalIF":1.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying discrepancy between indicated and actual oxygen flow rates delivered by Comweld Ezi-flow low and standard flowmeters under hyperbaric conditions: a technical report.","authors":"Yoav Aufgang, Bridget Devaney, Jason Chan, Ian Millar, Theo Tsouras","doi":"10.28920/dhm56.2.154-160","DOIUrl":"10.28920/dhm56.2.154-160","url":null,"abstract":"<p><strong>Introduction: </strong>During clinical use of extracorporeal membrane oxygenation (ECMO) in hyperbaric conditions at our centre, upward titration of indicated sweep gas flow rates is required to maintain adequate CO₂ clearance. This project measured the impact of hyperbaric pressure on oxygen flow rates delivered by the Comweld Ezi-Flow flowmeters used in our centre.</p><p><strong>Methods: </strong>Oxygen flow rates through Comweld Ezi-flow standard and low oxygen gas flowmeters were set at 101.3 kPa (1 atmosphere absolute [atm abs]) and then measured at intervals up to 284 kPa (2.8 atm abs) using a calibrated gas flow analyser, with cross verification against a small Douglas bag test type apparatus. During testing, the chamber was compressed and decompressed at a rate of 10 kPa·min⁻¹. Flow rates during chamber compression and decompression were compared.</p><p><strong>Results: </strong>The indicated rate of oxygen gas flow through the unadjusted flowmeters changed minimally - typically rising by a maximum of half of the diameter of the indicator ball. The actual (volumetric) flow, tested across indicated flow rates from 3 to 12 L·min⁻¹, was consistently reduced by approximately 50% as the chamber pressure increased from 101.3 to 284 kPa (1 to 2.8 atm abs). A slightly smaller reduction was observed when assessing the low flowmeter across the same pressure range; reductions of 40.0 and 43.3% were demonstrated at 0.3 to 0.6 L·min⁻¹ respectively. Differences in flow rates between compression and decompression were minor except at the very lowest flows.</p><p><strong>Conclusions: </strong>At 284 kPa (2.8 atm abs), actual volumetric flow of oxygen through Comweld Ezi-Flow flowmeters is dramatically reduced and this needs appropriate compensation to ensure therapeutic aims are achieved.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 2","pages":"154-160"},"PeriodicalIF":1.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recreational and technical rebreather fatalities and diving safety status.","authors":"Frauke Tillmans, Camilo Saraiva, Sherri Ferguson, Emmanuel Dugrenot, S Lesley Blogg","doi":"10.28920/dhm56.2.185-190","DOIUrl":"10.28920/dhm56.2.185-190","url":null,"abstract":"<p><strong>Introduction: </strong>The Divers Alert Network (DAN) aims to provide safety information for all types of diving. Assessing the number of active closed-circuit rebreather (CCR) divers is difficult, as pertinent information is often not available. This review aims to give an overview of global use and safety of CCR diving equipment from 2013-2022.</p><p><strong>Methods: </strong>Data were combined and assessed from various DAN internal and public sources on CCR diver demographics, fatalities, and CCR sales.</p><p><strong>Results: </strong>Over the past 10 years, the number of certified CCR divers has increased from an estimated 2,000 in 2013, to 3,000 in 2022. There has been an increase in growth in CCR sales over a five-year period from 2018, with around 25,000 to 35,000 units on the market today; rebreather divers are a growing community. There were 241 confirmed CCR fatalities from 2013-2022, mean 24 (SD 6) per year. Most fatal accidents involved dives made between 40-80 m (130-260 ft) depth. Cause of death is difficult to establish due to lack of detail and dive-specific training for the medical examiner. The estimated death rate is 1.8-3.8 deaths per 100,000 CCR dives although these values are derived from limited data.</p><p><strong>Conclusions: </strong>Not enough information is made available to address CCR accident analysis effectively, perhaps stemming from family reticence to discuss the incident, fear of litigation, and/or lack of diving knowledge reducing the useful information. DAN continues to collect CCR data, but increased collaboration between training bodies, equipment providers, and comprehensive reporting of incidents is needed to reveal the true picture.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 2","pages":"185-190"},"PeriodicalIF":1.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral arterial oxygen embolism as a complication of hyperbaric oxygen treatment: a case report.","authors":"Rahulkumar Ramchandani, Bridget Devaney, Ashish Jaison, Neil Banham, Stephan Roehr","doi":"10.28920/dhm56.2.198-202","DOIUrl":"10.28920/dhm56.2.198-202","url":null,"abstract":"<p><p>Cerebral arterial gas embolism (CAGE) is a recognised complication of diving-related barotrauma and of medical procedures whereby gas enters the vascular system. CAGE is a principal indication for hyperbaric oxygen treatment (HBOT). In contrast, CAGE resulting from HBOT itself is exceedingly rare. We describe the case of a 73-year-old man undergoing his first session of HBOT for a chronic lower limb wound, who developed acute focal neurological deficits during decompression. He had no known respiratory disease or smoking history. Immediate assessment demonstrated stable physiology. Initial computed tomography (CT) scan of the brain and neck vessels and perfusion imaging did not show any evidence of thrombus or intravascular gas, and partial neurological recovery occurred over several hours. Subsequent magnetic resonance imaging of the brain demonstrated acute infarction involving the left precentral and postcentral gyri. High-resolution CT chest revealed multiple bilateral thin-walled pulmonary cysts, including a left upper lobe cyst with an air-fluid level consistent with recent barotrauma. A transient broncho-venous fistula allowing arterial oxygen embolisation during decompression was considered the most plausible mechanism. The patient improved with supportive management and was discharged with minimal residuae. This case highlights an exceptionally rare but serious complication of HBOT and underscores the importance of vigilance during decompression and careful consideration of occult pulmonary pathology.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 2","pages":"198-202"},"PeriodicalIF":1.3,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of potential irrigation diluents following 'caustic cocktail' ingestion.","authors":"Adam Lee, Catherine Moore, Adam Griffiths","doi":"10.28920/dhm56.1.83-87","DOIUrl":"10.28920/dhm56.1.83-87","url":null,"abstract":"<p><p>Closed circuit rebreather (CCR) diving sets use soda lime, a sodium hydroxide-based 'scrubber' substance to remove CO₂ from exhaled breathing gas thus prolonging dive time and efficiency. Inadvertent water ingress into the set may result in reaction with the scrubber and a highly alkaline solution known as a 'caustic cocktail' may be formed. Ingestion or aspiration of this solution can cause severe chemical burns. Irrigation with freshwater is the mainstay of initial treatment of 'caustic cocktail' injuries in CCR divers. Published advice advises divers never to use acidic diluents to irrigate and neutralise a caustic cocktail solution due to concerns over the potentially exothermic nature of the neutralisation reaction. However, there is limited available evidence to support this advice, and it was felt that further research into the best treatment options available for caustic cocktails is required. This study used an in vitro model of an ingested caustic cocktail to investigate pH and temperature changes after adding different diluents (including acidic diluents orange juice or coca cola) to a solution of sodium hydroxide. Acidic diluents reduce pH significantly more than neutral diluents with a respective mean drop in pH of 5.99 compared to 0.78 (P = 0.015). There is no statistically significant difference in temperature change noted between the two types of diluent (P = 0.32) with no exothermia generated. We propose that orange juice or coca cola are more effective irrigation solutions than fresh or seawater, and that advice to divers who use CCRs could change.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"83-87"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scuba tank fill survey in Victoria, Australia, 1 July 2024 to 30 June 2025.","authors":"John Lippmann","doi":"10.28920/dhm56.1.48-51","DOIUrl":"10.28920/dhm56.1.48-51","url":null,"abstract":"<p><strong>Introduction: </strong>This study's aim was to determine the number of scuba tank fills done in Victoria, Australia from 1 July 2024 to 30 June 2025 to provide an estimate of the number of scuba dives conducted during that period and, from that, estimates of the fatality and decompression illness rates.</p><p><strong>Methods: </strong>Suppliers of compressed gas for scuba diving in Victoria were identified through internet searches, industry liaison and the Australasian Diving Safety Foundation records. Those identified were emailed an invitation to participate in the tank fill survey and provided with dedicated spreadsheets. Email reminders were sent to collect monthly data on air, nitrox and 'other' fills. Data were compiled and, at the end of the survey period, non-regular participants were approached to provide actual numbers or estimates of the year's fills.</p><p><strong>Results: </strong>Overall, 38/40 (95%) identified current suppliers participated in the survey, with 27 submitting regular monthly data and the remainder providing actual or estimated annual fills. There were 46,720 reported fills, including 39,386 air, 6,758 nitrox, and 576 others, with proportions of 84%, 15% and 1%, respectively. During that period, 11 scuba divers were treated for decompression illness (DCI) (eight of whom had dived locally) and there were two fatalities.</p><p><strong>Conclusions: </strong>It is estimated that around 50,000 scuba tank fills were provided, equating to approximately 50,000 dives conducted in Victorian waters during from 1 July 2024 to 30 June 2025. During that period, there were eight open circuit divers who had dived in Victoria treated for DCI and two scuba diving fatalities, yielding estimates of 16 DCI cases and four deaths per 100,000 dives.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"48-51"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An echo from the past: open access repository of over 10,000 annotated Doppler audio recordings of venous gas emboli.","authors":"S Lesley Blogg, Arian Azarang, Rachel Lance, Frauke Tillmans, Richard Moon, Virginie Papadopoulou, Peter Lindholm","doi":"10.28920/dhm56.1.8-12","DOIUrl":"10.28920/dhm56.1.8-12","url":null,"abstract":"<p><strong>Introduction: </strong>Doppler ultrasound measurements have been recorded since the 1970s across the world and provide a valuable data resource for learning, analysis, and potential training of deep learning algorithms to recognise and grade venous gas emboli (VGE) allowing assessment of decompression sickness (DCS) risk.</p><p><strong>Methods: </strong>We collected a 'big database' of Doppler recordings and associated metadata. Audio tapes with recorded Doppler data were converted to digital files, then cut into individual recordings and matched with their metadata, including subject and pressure profile information. The audio signals and their Doppler grades were then processed further for suitability to train an algorithm to identify VGE.</p><p><strong>Results: </strong>A total of 10,099 Doppler ultrasound recordings were compiled. Divers (n = ≤ 311; 170 identified, ≤ 141 unidentified) were male, with a median age of 31.5 years among the 170 identified divers. The maximum depth of the dives included ranged from 24 m (80 feet) to 91.4 m (300 feet). The timing of the Doppler measurements ranged from two minutes post-dive to 594 min post-dive, with a median time of 52 min. Breathing gases included air, nitrox, and heliox. DCS was noted in only 12 individuals. The dataset centred around lower VGE loads (Spencer Grades 0, I, and II).</p><p><strong>Conclusions: </strong>This database represents a landmark in DCS investigation as the audio dataset and metadata collected have been released under a public domain license for further use. The large number of data points has also allowed the development of a deep learning algorithm that can grade bubble loads without a human operator.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in the treatment of inner ear decompression sickness with hyperbaric oxygen therapy, a systematic review.","authors":"Rosanna J Stokes, Jonathan Marsden, Doug Watts, Gary Smerdon, Stephen D Hall, Lisa Bunn","doi":"10.28920/dhm56.1.71-82","DOIUrl":"10.28920/dhm56.1.71-82","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective of this review was to evaluate the effectiveness of hyperbaric oxygen therapy (HBOT) in the treatment of inner ear decompression sickness (IEDCS). Secondary objectives were to summarise the diver characteristics, HBOT parameters and outcome measures.</p><p><strong>Methods: </strong>All descriptive observational study designs including case series and individual case reports involving divers suffering IEDCS treated with HBOT were included. PubMed, Scopus, CINAHL and EMBASE were used to search for texts reporting the outcome for divers treated with HBOT. Eligible studies were appraised by two independent reviewers and any disagreements resolved via the third reviewer. Data were extracted using standardised tools and narrative synthesis was undertaken.</p><p><strong>Results: </strong>3,683 records were identified with 24 included in the final review representing 539 cases of IEDCS. Mean age was 44, average (in-water) dive depth 29 metres of seawater and dive duration 38 minutes. Mean onset of symptoms was 32 minutes and 74% had a right sided lesion. Only 37% had residual symptoms on discharge despite 68% showing dysfunction on laboratory testing. Follow-up duration and assessment methods were variable. Vestibular rehabilitation was underutilised and only 46% of divers went on to have patent foramen ovale (PFO) screening despite the well-established link to IEDCS.</p><p><strong>Conclusions: </strong>A standardised method of examination and assessment of symptoms should be considered along with vestibular rehabilitation (or referral to this service). All divers should be counselled on PFO screening. A standard 3-month follow-up is recommended to allow for assessment of residual dysfunction / symptoms and discussion regarding returning to diving. Further research should focus on assessment of vestibular deficit / symptoms over time to assess efficacy of HBOT including the effects of delay to recompression and number of treatments. Laboratory testing should be utilised to determine the mechanism of injury and recovery.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"71-82"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision regret and shared decision-making in patients undergoing hyperbaric oxygen therapy.","authors":"Joost R Meijering, Nurseda Risvanoglu, Julia D van Waard, Johanna H Nederhoed, Rigo Hoencamp, Robert A van Hulst, Dirk T Ubbink","doi":"10.28920/dhm56.1.52-58","DOIUrl":"10.28920/dhm56.1.52-58","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperbaric oxygen therapy (HBOT) is used for various medical conditions. HBOT is demanding and varies in effectiveness. This intensity combined with logistical challenges may lead to patients regretting undergoing HBOT. Therefore, shared decision-making (SDM) seems applicable when considering HBOT. The goal of this study was to assess the level of SDM as perceived by HBOT patients and relate this to post-hoc regret about choosing HBOT.</p><p><strong>Methods: </strong>Patients referred for ≥ 10 sessions HBOT, were recruited for this prospective cohort study. Participants completed the SDM-Q-9 and SDM-K-Q questionnaires within one week of HBOT initiation. At least six weeks after HBOT completion or discontinuation participants completed the Decision Regret Scale (DRS) questionnaire. Multivariable linear regression analysis was applied to find factors influencing decision regret and SDM.</p><p><strong>Results: </strong>Sixty-two patients (mean age 61.5 years; 36 female), primarily treated for radiation-related injuries, were included. Minor complications, including fatigue and temporary visual changes, were common. Mean SDM-Q-9 and SDM-K-Q scores were 61.9% and 72.1%, respectively. Among 54 patients completing the DRS, mean regret score was 13.4%. Lower regret correlated with symptom improvement (B = -16.56, P = 0.036) and more side effects (B = -6.81, P = 0.014). Males tended to report more regret (B = 8.26, P = 0.081), while age and SDM-Q-9 scores were not significant predictors. No factors significantly affected SDM-Q-9 scores.</p><p><strong>Conclusions: </strong>HBOT patients reported limited involvement in decision-making and low levels of regret. Interestingly, minor complications were associated with less regret, suggesting complex dynamics in patient experience and treatment justification. These findings highlight the importance of individualised shared decision-making and patient education in the context of HBOT to ensure treatment choice aligns with patient values and expectations.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}