Diving and hyperbaric medicine最新文献_第2页

The use of hyperbaric oxygen for avascular necrosis of the femoral head and femoral condyle: a single centre's experience over 30 years. 使用高压氧治疗股骨头和股骨髁的血管性坏死：一个中心 30 年来的经验。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-06-30 DOI: 10.28920/dhm54.2.92-96

John Rb Currie, Ian C Gawthrope, Neil D Banham

{"title":"The use of hyperbaric oxygen for avascular necrosis of the femoral head and femoral condyle: a single centre's experience over 30 years.","authors":"John Rb Currie, Ian C Gawthrope, Neil D Banham","doi":"10.28920/dhm54.2.92-96","DOIUrl":"10.28920/dhm54.2.92-96","url":null,"abstract":"Introduction: Avascular necrosis (AVN) is a rare progressive degenerative disease leading to bone and joint destruction. Patients often require surgical intervention. Femoral AVN is the most common anatomical location. Hyperbaric oxygen treatment (HBOT) has been shown to be effective in AVN. We present data collected from one centre over a 30-year period and compare the results with other published data.Methods: A retrospective chart review of all patients receiving HBOT for AVN at Fremantle and Fiona Stanley Hospitals since 1989 was performed. The primary outcome was radiological appearance using the Steinberg score, with secondary outcomes being subjective improvement, the need for joint replacement surgery and rates of complications.Results: Twenty-one joints in 14 patients (14 femoral heads and seven femoral condyles) were treated with HBOT since 1989. Two patients were excluded. Within the femoral head group, nine of the 14 joints (64%) had stable or improved magnetic resonance imaging (MRI) scans post treatment and at six months (minimum); 10 joints (71%) had good outcomes subjectively, three joints required surgical intervention, and three patients developed mild aural barotrauma. Within the femoral condyle group, all five joints had stable or improved post-treatment MRI scans (four had visible improvement in oedema and/or chondral stability), four joints reported good outcomes subjectively, none of the patients required surgical intervention (follow-up > six months).Conclusions: This single centre retrospective study observed prevention of disease progression in femoral AVN with the use of HBOT, comparable to other published studies. This adds to the body of evidence that HBOT may have a significant role in the treatment of femoral AVN.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 2","pages":"92-96"},"PeriodicalIF":0.8,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317150","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}

引用次数: 0

Formulating policies and procedures for managing diving related deaths: a whole of state engagement from frontline and hospital services in Tasmania. 制定管理潜水相关死亡的政策和程序：塔斯马尼亚州前线和医院服务的全州参与。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-06-30 DOI: 10.28920/dhm54.2.86-91

Elizabeth J Elliott, Karl Price, Bernard Peters

{"title":"Formulating policies and procedures for managing diving related deaths: a whole of state engagement from frontline and hospital services in Tasmania.","authors":"Elizabeth J Elliott, Karl Price, Bernard Peters","doi":"10.28920/dhm54.2.86-91","DOIUrl":"10.28920/dhm54.2.86-91","url":null,"abstract":"Introduction: Tasmania is a small island state off the southern edge of Australia where a comparatively high proportion of the 558,000 population partake in recreational or occupational diving. While diving is a relatively safe sport and occupation, Tasmania has a significantly higher diving death rate per head of population than other States in Australia (four times the national diving mortality rate).Methods: Three compressed gas diving deaths occurred in seven months between 2021-2022 prompting a review of the statewide approach for the immediate response of personnel to diving-related deaths. The review engaged first responders including the Police Marine and Rescue Service, hospital-based departments including the Department of Hyperbaric and Diving Medicine, and the mortuary and coroner's office.Results: An aide-mémoire for all craft groups, digitalised checklists for first responders (irrespective of diving knowledge), and a single-paged algorithm to highlight inter-agency communication pathways in the event of a diving death were designed to enhance current practices and collaboration.Conclusions: If used, these aids for managing diving related deaths should ensure that time-critical information is appropriately captured and stored to optimise information provided for the coronial investigation.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 2","pages":"86-91"},"PeriodicalIF":0.8,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141317037","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}

引用次数: 0

Hyperbaric oxygen treatment for infants: retrospective analysis of 54 patients treated in two tertiary care centres. 婴儿高压氧治疗：对两个三级医疗中心治疗的 54 名患者的回顾性分析。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.9-15

Kubra Ozgok Kangal, Bengusu Mirasoglu

{"title":"Hyperbaric oxygen treatment for infants: retrospective analysis of 54 patients treated in two tertiary care centres.","authors":"Kubra Ozgok Kangal, Bengusu Mirasoglu","doi":"10.28920/dhm54.1.9-15","DOIUrl":"10.28920/dhm54.1.9-15","url":null,"abstract":"Introduction: We aimed to analyse the outcomes of hyperbaric oxygen treatment (HBOT) and describe difficulties encountered in infants, a rare patient population in this therapeutic intervention, with limited scientific reports.Methods: This was a retrospective analysis of patients 12 months old or younger who underwent HBOT in two different institutions. Demographic data, clinical presentation, HBOT indication, chamber type, oxygen delivery method, total number of treatments, outcome and complications were extracted from clinical records.Results: There were 54 infants in our study. The patients' median age was 3.5 (range 0-12) months. The major HBOT indication was acute carbon monoxide intoxication (n = 32). A total of 275 HBOT treatments were administered, mostly performed in multiplace chambers (n = 196, 71%). Only one patient (2%) required mechanical ventilation. Acute signs were fully resolved in the most patients (n = 40, 74%). No complications related to HBOT were reported.Conclusions: This study suggests that HBOT may be a safe and effective treatment for infants. Paediatricians should consider HBOT when indicated in infants even for the preterm age group.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 1","pages":"9-15"},"PeriodicalIF":0.8,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174147","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}

引用次数: 0

Efficacy of searching in biomedical databases beyond MEDLINE in identifying randomised controlled trials on hyperbaric oxygen treatment. 在 MEDLINE 之外的生物医学数据库中搜索高压氧治疗随机对照试验的效果。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.2-8

Hira Khan, Mohammad Sindeed Islam, Manvinder Kaur, Joseph K Burns, Cole Etherington, Pierre-Marc Dion, Sarah Alsayadi, Sylvain Boet

{"title":"Efficacy of searching in biomedical databases beyond MEDLINE in identifying randomised controlled trials on hyperbaric oxygen treatment.","authors":"Hira Khan, Mohammad Sindeed Islam, Manvinder Kaur, Joseph K Burns, Cole Etherington, Pierre-Marc Dion, Sarah Alsayadi, Sylvain Boet","doi":"10.28920/dhm54.1.2-8","DOIUrl":"10.28920/dhm54.1.2-8","url":null,"abstract":"Introduction: Literature searches are routinely used by researchers for conducting systematic reviews as well as by healthcare providers, and sometimes patients, to quickly guide their clinical decisions. Using more than one database is generally recommended but may not always be necessary for some fields. This study aimed to determine the added value of searching additional databases beyond MEDLINE when conducting a literature search of hyperbaric oxygen treatment (HBOT) randomised controlled trials (RCTs).Methods: This study consisted of two phases: a scoping review of all RCTs in the field of HBOT, followed by a a statistical analysis of sensitivity, precision, 'number needed to read' (NNR) and 'number unique' included by individual biomedical databases. MEDLINE, Embase, Cochrane Central Register of Control Trials (CENTRAL), and Cumulated Index to Nursing and Allied Health Literature (CINAHL) were searched without date or language restrictions up to December 31, 2022. Screening and data extraction were conducted in duplicate by pairs of independent reviewers. RCTs were included if they involved human subjects and HBOT was offered either on its own or in combination with other treatments.Results: Out of 5,840 different citations identified, 367 were included for analysis. CENTRAL was the most sensitive (87.2%) and had the most unique references (7.1%). MEDLINE had the highest precision (23.8%) and optimal NNR (four). Among included references, 14.2% were unique to a single database.Conclusions: Systematic reviews of RCTs in HBOT should always utilise multiple databases, which at minimum include MEDLINE, Embase, CENTRAL and CINAHL.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 1","pages":"2-8"},"PeriodicalIF":0.8,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174144","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}

引用次数: 0

Time to shock people. 是时候震撼人心了

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.73-74

Gerard Laden, Bruce Mathew, Ananthakrishnan Ananthasayanam

引用次数: 0

Decompression illness: a comprehensive overview. 减压病：全面概述。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.suppl.1-53

Simon J Mitchell

{"title":"Decompression illness: a comprehensive overview.","authors":"Simon J Mitchell","doi":"10.28920/dhm54.1.suppl.1-53","DOIUrl":"10.28920/dhm54.1.suppl.1-53","url":null,"abstract":"Decompression illness is a collective term for two maladies (decompression sickness [DCS] and arterial gas embolism [AGE]) that may arise during or after surfacing from compressed gas diving. Bubbles are the presumed primary vector of injury in both disorders, but the respective sources of bubbles are distinct. In DCS bubbles form primarily from inert gas that becomes dissolved in tissues over the course of a compressed gas dive. During and after ascent ('decompression'), if the pressure of this dissolved gas exceeds ambient pressure small bubbles may form in the extravascular space or in tissue blood vessels, thereafter passing into the venous circulation. In AGE, if compressed gas is trapped in the lungs during ascent, pulmonary barotrauma may introduce bubbles directly into the pulmonary veins and thence to the systemic arterial circulation. In both settings, bubbles may provoke ischaemic, inflammatory, and mechanical injury to tissues and their associated microcirculation. While AGE typically presents with stroke-like manifestations referrable to cerebral involvement, DCS can affect many organs including the brain, spinal cord, inner ear, musculoskeletal tissue, cardiopulmonary system and skin, and potential symptoms are protean in both nature and severity. This comprehensive overview addresses the pathophysiology, manifestations, prevention and treatment of both disorders.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 1Suppl","pages":"1-53"},"PeriodicalIF":0.8,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305207","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}

引用次数: 0

Review of saturation decompression procedures used in commercial diving. 回顾商业潜水中使用的饱和减压程序。

IF 0.9 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.23-38

Jean-Pierre Imbert, Lyubisa Matity, Jean-Yves Massimelli, Philip Bryson

{"title":"Review of saturation decompression procedures used in commercial diving.","authors":"Jean-Pierre Imbert, Lyubisa Matity, Jean-Yves Massimelli, Philip Bryson","doi":"10.28920/dhm54.1.23-38","DOIUrl":"10.28920/dhm54.1.23-38","url":null,"abstract":"Introduction: This is a review of commercial heliox saturation decompression procedures. The scope does not include compression, storage depth or bell excursion dive procedures. The objectives are to: identify the sources of the procedures; trace their evolution; describe the current practice; and detect relevant trends.Methods: Eleven international commercial diving companies provided their diving manuals for review under a confidentiality agreement.Results: Modern commercial diving saturation procedures are derived from a small number of original procedures (United States Navy, Comex, and NORSOK). In the absence of relevant scientific studies since the late 80's, the companies have empirically adapted these procedures according to their needs and experience. Such adaptation has caused differences in decompression rates shallower than 60 msw, decompression rest stops and the decision to decompress linearly or stepwise. Nevertheless, the decompression procedures present a remarkable homogeneity in chamber PO2 and daily decompression rates when deeper than 60 msw. The companies have also developed common rules of good practice; no final decompression should start with an initial ascending excursion; a minimum hold is required before starting a final decompression after an excursion dive. Recommendation is made for the divers to exercise during decompression.Conclusions: We observed a trend towards harmonisation within the companies that enforce international procedures, and, between companies through cooperation inside the committees of the industry associations.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 1","pages":"23-38"},"PeriodicalIF":0.9,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11065503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174150","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}

引用次数: 0

Secondary deterioration in a patient with cerebral and coronary arterial gas embolism after brief symptom resolution: a case report. 一名脑部和冠状动脉气体栓塞患者在症状短暂缓解后病情继发恶化：病例报告。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.61-64

Ryota Tsushima, Kosuke Mori, Shohei Imaki

{"title":"Secondary deterioration in a patient with cerebral and coronary arterial gas embolism after brief symptom resolution: a case report.","authors":"Ryota Tsushima, Kosuke Mori, Shohei Imaki","doi":"10.28920/dhm54.1.61-64","DOIUrl":"10.28920/dhm54.1.61-64","url":null,"abstract":"Introduction: Hyperbaric oxygen treatment (HBOT) is recommended for arterial gas embolism (AGE) with severe symptoms. However, once symptoms subside, there may be a dilemma to treat or not.Case presentation: A 71-year-old man was noted to have a mass shadow in his left lung, and a transbronchial biopsy was performed with sedation. Flumazenil was intravenously administered at the end of the procedure. However, the patient remained comatose and developed bradycardia, hypotension, and ST-segment elevation in lead II. Although the ST changes spontaneously resolved, the patient had prolonged disorientation. Whole- body computed tomography revealed several black rounded lucencies in the left ventricle and brain, confirming AGE. The patient received oxygen and remained supine. His neurological symptoms gradually improved but worsened again, necessitating HBOT. HBOT was performed seven times, after which neurological symptoms resolved almost completely.Conclusions: AGE can secondarily deteriorate after symptoms have subsided. We recommend that HBOT be performed promptly once severe symptoms appear, even if they resolve spontaneously.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 1","pages":"61-64"},"PeriodicalIF":0.8,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174151","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}

引用次数: 0

Chain of events analysis in diving accidents treated by the Royal Netherlands Navy 1966-2023. 1966-2023 年荷兰皇家海军处理的潜水事故的事件链分析。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.39-46

Benjamin L Turner, Pieter-Jan Am van Ooij, Thijs T Wingelaar, Rob A van Hulst, Edwin L Endert, Paul Clarijs, Rigo Hoencamp

{"title":"Chain of events analysis in diving accidents treated by the Royal Netherlands Navy 1966-2023.","authors":"Benjamin L Turner, Pieter-Jan Am van Ooij, Thijs T Wingelaar, Rob A van Hulst, Edwin L Endert, Paul Clarijs, Rigo Hoencamp","doi":"10.28920/dhm54.1.39-46","DOIUrl":"10.28920/dhm54.1.39-46","url":null,"abstract":"Introduction: Diving injuries are influenced by a multitude of factors. Literature analysing the full chain of events in diving accidents influencing the occurrence of diving injuries is limited. A previously published 'chain of events analysis' (CEA) framework consists of five steps that may sequentially lead to a diving fatality. This study applied four of these steps to predominately non-lethal diving injuries and aims to determine the causes of diving injuries sustained by divers treated by the Diving Medical Centre of the Royal Netherlands Navy.Methods: This retrospective cohort study was performed on diving injuries treated by the Diving Medical Centre between 1966 and 2023. Baseline characteristics and information pertinent to all four steps of the reduced CEA model were extracted and recorded in a database.Results: A total of 288 cases met the inclusion criteria. In 111 cases, all four steps of the CEA model could be applied. Predisposing factors were identified in 261 (90%) cases, triggers in 142 (49%), disabling agents in 195 (68%), and 228 (79%) contained a (possible-) disabling condition. The sustained diving injury led to a fatality in seven cases (2%). The most frequent predisposing factor was health conditions (58%). Exertion (19%), primary diver errors (18%), and faulty equipment (17%) were the most frequently identified triggers. The ascent was the most frequent disabling agent (52%).Conclusions: The CEA framework was found to be a valuable tool in this analysis. Health factors present before diving were identified as the most frequent predisposing factors. Arterial gas emboli were the most lethal injury mechanism.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"54 1","pages":"39-46"},"PeriodicalIF":0.8,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11227959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174124","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}

引用次数: 0

Equipoise: an important ethical consideration when contemplating participation in a randomised controlled trial of hyperbaric oxygen treatment in necrotising soft tissue infections. Equipoise：考虑参与高压氧治疗坏死性软组织感染随机对照试验时的重要伦理考虑因素。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2024-03-31 DOI: 10.28920/dhm54.1.57-60

Bridget Devaney

引用次数: 0