Diving and hyperbaric medicine最新文献

{"title":"Hyperbaric oxygen treatment of neonates: a case series.","authors":"Gizem Kavram, Beril Yasa, Meltem Bor, Leyla Bilgin, Elmas Zeynep Ince, Bengusu Mirasoglu, Emine Asuman Coban","doi":"10.28920/dhm55.3.284-288","DOIUrl":"10.28920/dhm55.3.284-288","url":null,"abstract":"<p><p>Hyperbaric oxygen therapy (HBOT) administers oxygen under high pressure, mainly for decompression illness, carbon monoxide intoxication, wound healing, infections, and acute peripheral arterial ischaemia. There has been limited use in newborn infants. This case series aims to highlight the potential role of HBOT in management of rare and challenging conditions encountered in the neonatal period. Although HBOT is widely available, its application in newborns remains limited and not well established. We present three neonatal cases: acute peripheral ischaemia; vascular compromise due to thrombosis and compartment syndrome; and a non-healing surgical wound following omphalocele repair. We aim to emphasise the potential clinical benefit and discuss the safety profile of HBOT in select life or limb threatening neonatal pathologies. These cases demonstrate that HBOT, when use as an adjunctive therapy, may contribute to tissue salvage and overall improved outcomes in critically ill neonates. Our intention is to raise awareness and contribute to the limited literature regarding neonatal HBOT, particularly in contexts where usual treatment options are insufficient.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"284-288"},"PeriodicalIF":1.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130357","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":"Psychosis and diving.","authors":"Abraham L Querido, Thijs T Wingelaar","doi":"10.28920/dhm55.2.173-179","DOIUrl":"10.28920/dhm55.2.173-179","url":null,"abstract":"<p><p>Psychotic disorders, characterised by impaired reality testing and a spectrum of symptoms, present significant challenges in assessing fitness for diving. While diving can be a safe and rewarding activity, the unique physiological and environmental stresses of hyperbaric conditions can exacerbate psychotic vulnerability or mimic psychotic symptoms. This article reviews the literature on psychosis and diving, exploring the implications of psychotic disorders, psychotropic medications, and hyperbaric effects. It highlights the critical importance of illness insight, the absence of comorbid conditions, and complete remission in determining diving fitness. Key recommendations include avoiding deep dives, careful evaluation of medication use, and a nuanced differentiation between chronic and transient psychoses. By synthesizing existing evidence, this article aims to guide diving medicine professionals in making informed decisions about psychosis and diving suitability.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"173-179"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340015","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":"Challenges in the administration of hyperbaric oxygen therapy (HBOT) for complicated cases in a tertiary care setting.","authors":"Divya Singh, Chandrasekhar Mohanty, Rohit Verma, Subhranshu Kumar","doi":"10.28920/dhm55.2.211-212","DOIUrl":"10.28920/dhm55.2.211-212","url":null,"abstract":"","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"211-212"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339953","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":"Post-traumatic wound infection after diving caused by Vibrio alginolyticus: a case report.","authors":"Julia Cebrián-López, Francisco Jover-Díaz, Ana Infante-Urrios, Pedro M Piqueras-Vidal, Victoria Ortiz de la Tabla-Duccasse","doi":"10.28920/dhm55.2.199-202","DOIUrl":"10.28920/dhm55.2.199-202","url":null,"abstract":"<p><p>Vibrio alginolyticus is a facultatively anaerobic, Gram-negative bacillus that is a common component of marine flora. Infections caused by Vibrio alginolyticus are rare and typically occur following exposure to seawater or marine animals. This report details the clinical presentation and follow-up of a 65-year-old immunocompetent male who developed a wound infection due to Vibrio alginolyticus. Advanced diagnostic tools, such as MALDI-TOF mass spectrometry, can enhance the identification of these bacteria. Sport clinicians need to recognise Vibrio infections in seawater-contaminated wounds, as infections may be serious and the therapeutic approach may differ from conventional treatments.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"199-202"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340014","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":"Gastric barotrauma following submarine escape training.","authors":"Jan Risberg, Simon Phillips, Nils Sletteskog, Ketil Grong","doi":"10.28920/dhm55.2.195-198","DOIUrl":"10.28920/dhm55.2.195-198","url":null,"abstract":"<p><p>Seventeen case reports of gastric barotrauma following diving have been published previously. We report the case of a 32-year-old healthy male suffering gastric barotrauma in 1987. The incident happened during a military submarine exercise. The patient escaped the submarine at 150 metres water depth but was entangled for a short time in the escape tower and, likely distressed and in a state of panic, swallowed significant amounts of air. He experienced abdominal pain during ascent. Given the special circumstances of this event, medical personnel primarily expected symptoms to be caused by decompression sickness and initiated therapeutic recompression on site. No improvement occurred during recompression, and he was admitted to hospital. Abdominal X-ray disclosed free abdominal gas which was exsufflated in the emergency room. Emergency abdominal surgery revealed a 9 cm rupture of the lesser gastric curvature which was sutured. Recovery was uneventful. We discuss the proper approach to divers experiencing abdominal pain following ascent.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"195-198"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340011","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":"Electroencephalographic (EEG) changes accompanying normal breathing of concentrated oxygen (hyperoxic ventilation) by healthy adults: a systematic review.","authors":"Lachlan D Barnes, Luke E Hallum, Xavier Ce Vrijdag","doi":"10.28920/dhm55.2.154-163","DOIUrl":"10.28920/dhm55.2.154-163","url":null,"abstract":"<p><strong>Introduction: </strong>Divers often increase their fraction of inspired oxygen (FIO₂) to decrease their risk of decompression sickness. However, breathing elevated pressures of oxygen can cause central nervous system oxygen toxicity (CNS-OT). This study aimed to review the literature describing the effect of hyperoxia on the electroencephalogram (EEG), thus exploring the potential for real-time detection of an impending CNS-OT seizure.</p><p><strong>Methods: </strong>We searched Medline, Embase, Scopus, and Web of Science for articles that reported EEG measures accompanying hyperoxic ventilation (FIO₂ = 1.0 ± hyperbaric pressure) in healthy participants. We included peer-reviewed journal articles, books, and government reports with no language or date restrictions. Randomised controlled trials and cross-over studies were included; case reports were excluded. We used the Newcastle-Ottawa scale to evaluate evidence quality.</p><p><strong>Results: </strong>Our search strategy returned 1,025 unique abstracts; we analysed the full text of 46 articles; 22 articles (16 studies) were included for review. Study cohorts were typically small and comprised of male non-divers. We discovered a variety of EEG analysis methods: studies performed spectral analysis (n = 12), the analysis of sensory-evoked potentials (n = 4), connectivity/complexity analysis (n = 3), source localisation (n = 1), and expert qualitative analyses (n = 4). Studies of severe exposures (long duration at hyperbaric pressure) typically reported qualitative measures, and studies of mild exposures typically reported quantitative measures.</p><p><strong>Conclusions: </strong>There is a need for a large randomised controlled trial reporting quantitative measures to better understand the effect of hyperoxia on the EEG, thus enabling the development of real-time monitoring of CNS-OT risk.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"154-163"},"PeriodicalIF":0.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339971","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":"Oxygen treatment and retrieval pathways of divers with diving-related conditions in Townsville, Australia: a 15-year retrospective review.","authors":"Denise F Blake, Melissa Crowe, Daniel Lindsay, Richard Turk, Simon J Mitchell, Neal W Pollock","doi":"10.28920/dhm55.2.79-90","DOIUrl":"10.28920/dhm55.2.79-90","url":null,"abstract":"<p><strong>Introduction: </strong>First aid for injured divers includes oxygen delivery prior to definitive care. Delay to specialist assessment and/or hyperbaric oxygen treatment (HBOT) may be due to dive site remoteness and limited access to facilities. Townsville has the only hyperbaric facility along the Great Barrier Reef. Analysis of oxygen therapy and retrieval pathways of divers treated in Townsville may assist with establishing future education strategies and resource allocation.</p><p><strong>Methods: </strong>Data were retrospectively collected on divers assessed at the Townsville hyperbaric medicine unit from November 2003 through December 2018. Demographics, dive incident location, oxygen treatment, retrieval platform and pathway, and initial disease grade were reviewed. Data are presented as frequencies and percentages.</p><p><strong>Results: </strong>A total of 306 cases were included (184 males). Divers typically received oxygen therapy (87%, 267/305 known) prior to specialist review. The non-rebreather mask was the most frequently used (44%, 28/63) followed by in-water recompression (24%, 15/63). While 34% of the divers were retrieved from the scene (n = 104), only 11 (11%, 11/104) were retrieved directly to Townsville. Most divers initially classified as severe were retrieved from the scene (82%, 27/33), only two directly to Townsville. Fifteen cases had three retrieval legs (5%, 15/306).</p><p><strong>Conclusions: </strong>Most injured divers received oxygen first aid and were transported to Townsville for definitive care with a variable number of retrieval stages. Continuing education of retrieval physicians should address knowledge of diving related injuries and highlight cases that may benefit from expedited transfer.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"79-90"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340013","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":"Safety and efficacy of continuous glucose monitoring devices in individuals with diabetes undergoing hyperbaric oxygen therapy: a scoping review.","authors":"Glen Katsnelson, Marcus Salvatori, George Djaiani, Elise Greer, Jordan Tarshis, Rita Katznelson","doi":"10.28920/dhm55.2.164-172","DOIUrl":"10.28920/dhm55.2.164-172","url":null,"abstract":"<p><strong>Introduction: </strong>Continuous glucose monitoring devices (CGMs) have emerged as an effective approach to optimise glycaemic control for individuals living with diabetes mellitus. Despite CGMs offering improved patient satisfaction and quality of life, they have been primarily validated for outpatient and home use. This has posed a challenge for patients and providers who wish to incorporate CGMs into clinical settings such as hyperbaric oxygen therapy (HBOT). Those with advanced diabetes mellitus who have diabetic foot ulcers that are refractory to treatment are among the most prevalent users of HBOT. However, those who prefer to use their CGM during HBOT face uncertainty regarding the accuracy and safety of their device under hyperbaric conditions.</p><p><strong>Methods: </strong>The product specifications of commonly used CGMs were collated. In addition, a scoping review of the literature was conducted where Medline, Embase, and Scopus were searched for reports that assess the accuracy or safety of CGMs in hyperbaric conditions.</p><p><strong>Results: </strong>The product specifications of commonly used CGMs by Dexcom, Abbott, Medtronic, and Senseonics demonstrate a maximum validated pressure of approximately 106 kPa (1.06 atmospheres absolute). Our literature search identified five reports, of which four focused on accuracy and one focused on safety of CGMs in hyperbaric conditions. Treatments were conducted in multiplace chambers and cumulatively described 39 participants, of whom 12 have diabetes. Although heterogeneous in nature, the reports generally supported the safety and accuracy of CGMs in hyperbaric conditions.</p><p><strong>Conclusions: </strong>The safety and accuracy of using CGMs during HBOT warrants further investigation. CGMs have not been validated for repeated exposure to hyperbaric conditions and should not be used in oxygen pressurised monoplace chambers until further safety data is available. We provide practical recommendations for use of CGMs in multiplace chambers.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"164-172"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340016","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":"Shared decision-making when considering hyperbaric oxygen therapy: a systematic review.","authors":"Joost R Meijering, Nurseda Risvanoglu, Johanna H Nederhoed, Rigo Hoencamp, Robert A van Hulst, Dirk T Ubbink","doi":"10.28920/dhm55.2.180-185","DOIUrl":"10.28920/dhm55.2.180-185","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperbaric oxygen therapy (HBOT) is a treatment modality used for various non-acute medical conditions, ranging from ischaemic diabetic ulcers to late post-radiation damage. Despite its wide application, HBOT is often time-consuming, requires multiple sessions, and can be physically and psychologically challenging for patients, contributing to high drop-out rates. In addition, treatment results can vary significantly. These challenges suggest the need for more patient-centred approaches, such as shared decision-making (SDM), to improve patient engagement, satisfaction, and adherence to treatment. SDM, which involves patients in the decision-making process, could potentially improve outcomes and reduce dropout rates. This systematic review presents currently available evidence on the extent of SDM in patients eligible for HBOT.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in the Medline, Embase, TRIP and Cochrane Central databases, from inception up to 29 August 2024, to find all studies with original data on SDM when considering HBOT as a treatment option. Study selection was conducted by two reviewers independently. Desired study outcomes were the application and observed levels of SDM.</p><p><strong>Results: </strong>The search yielded 988 articles of which 24 appeared eligible. After assessing the inclusion criteria and outcomes in the full text articles, zero remained for inclusion: none reported on patient involvement in the decision-making process regarding HBOT. However, six articles did mention that SDM should be an important element when developing clinical practice guidelines for HBOT.</p><p><strong>Conclusions: </strong>Despite the obvious need for preference-sensitive decision-making in HBOT, there is no scientific evidence available on this topic. Possibly, physicians and patients consider HBOT as a last-resort or even the only treatment option. Consequently, involving the patient's preference regarding HBOT in the decision-making process is rarely documented. Hence, more awareness of the need for SDM is advocated when considering HBOT, which should be corroborated by research in this area.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"180-185"},"PeriodicalIF":1.1,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12520998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340017","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":"Diving practices in technical divers' community and behaviour towards self-reported unusual symptoms.","authors":"Emmanuel Gouin, David Pm Monnot, Thierry Michot, François Guerrero, Jean-Éric Blatteau","doi":"10.28920/dhm55.2.114-125","DOIUrl":"10.28920/dhm55.2.114-125","url":null,"abstract":"<p><strong>Introduction: </strong>The use of gas mixtures containing helium for deep recreational diving is increasingly common, involving complex logistics and decision-making compromises. The characteristics and inherent risks of this practice remain poorly documented. This study aims to provide an epidemiological inventory of practices and diving-related incidents within the technical diving community.</p><p><strong>Methods: </strong>An international online survey was disseminated on social networks targeting certified trimix divers. It collected demographic data, diving experience, and dive management practices, along with self-reported unusual symptoms, treatments, and outcomes following trimix dives.</p><p><strong>Results: </strong>A total of 558 questionnaires were analysed, predominantly from males (92%), mostly over 46 years old (61%), with high certification levels and recreational diving purposes. Forty-two percent reported one or more medical risk factors related to diving. Rebreather use was prevalent (79% at least occasionally). Decompression was primarily managed using compartmental models (85%) with gradient-factors adjustment. Dive planning varied significantly among individuals. Gas density at depth frequently exceeded the current recommendations. Ten percent had experienced symptoms suggestive of gas toxicity, mainly related to nitrogen narcosis. Thirty-six percent (199/558) reported experiencing, at least once, symptoms of diving-related incidents, with 61% (n = 121/199) expressing certainty. In 48% (120/261) of incidents involving decompression sickness (DCS) or breathing symptoms, no treatment was initiated. Among episodes involving DCS symptoms (n = 254), 42% received normobaric oxygen, and 23% sought medical advice, while 16% were treated with hyperbaric oxygen. Only 2.5% reported probable long-lasting sequelae.</p><p><strong>Conclusions: </strong>The diversity of practices highlights the lack of robust scientific data supporting them. The accident rate in mixed-gas diving may be higher than in typical scuba air diving, though mostly of mild severity. Treatment appears to be neglected despite divers' high knowledge levels. Continued research into decompression and the physiological effects of these dives is essential, along with ongoing awareness and education efforts in diving first aid within this exposed community.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 2","pages":"114-125"},"PeriodicalIF":0.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339956","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}