Diving and hyperbaric medicine最新文献

{"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654604/pdf/","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":"OA","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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654609/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Effects of fluid loss on the physiology of closed-circuit rebreather divers after 100- and 45-metre dives by Tuominen, et al.'","authors":"Peter T Wilmshurst, Christopher Edge","doi":"10.28920/dhm56.1.96-97","DOIUrl":"10.28920/dhm56.1.96-97","url":null,"abstract":"","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"96-97"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510653","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654605/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to comment by Peter T Wilmhurst and Christopher Edge.","authors":"Laura J Tuominen, Anne K Räisänen-Sokolowski, Richard V Lundell","doi":"10.28920/dhm56.1.97-98","DOIUrl":"10.28920/dhm56.1.97-98","url":null,"abstract":"","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"97-98"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510225","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654613/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transgender people and occupational diving: a new challenge for diving physicians?","authors":"Pieter-Jan Am van Ooij, Annemarije R Bek, Robert A van Hulst","doi":"10.28920/dhm56.1.59-70","DOIUrl":"10.28920/dhm56.1.59-70","url":null,"abstract":"<p><p>The gender identity of transgender people is not fully aligned with their sex assigned at birth. It has been estimated that approximately 355 of 100,000 people in the general population consider themselves transgender. Transgender people are increasingly choosing to transition through gender-affirming hormone therapy, including treatment with testosterone or oestrogens and gender-affirming surgeries. Occupational diving is performed in a unique, highly hostile physiological environment. An occupational diver should be free of pulmonary, cardiovascular, neurological, and psychological risk factors that could increase the risk of diving-associated adverse events. Dive medical assessments can identify these risk factors. The increasing number of people openly identifying as transgender raises the likelihood that more will want to participate in occupational diving. To date, however, no guidelines have been specifically designed for safe occupational diving by transgender individuals. This review, involving 43 systematic reviews and/or meta-analyses, was therefore designed to assess the long-term health effects in transgender individuals and how these influence occupational diving. Although transgender people face some additional health risks that could affect occupational diving, these risks can be managed by adhering to regular occupational fitness-to-dive guidelines.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"59-70"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510265","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":"Review of excursion procedures used in commercial heliox saturation diving.","authors":"Jean-Pierre Imbert, Lyubisa Matity, Jean-Yves Massimelli, Christian Cadieux, Jan Risberg, Philip Bryson","doi":"10.28920/dhm56.1.21-40","DOIUrl":"10.28920/dhm56.1.21-40","url":null,"abstract":"<p><strong>Introduction: </strong>This study reviews heliox saturation procedures used in offshore commercial diving and focuses on bell excursion dives. It excludes initial compression and final decompression. Our first objective was to trace the history and the reasons behind the successive changes that led to the current practice. Our second objective was to review the current practice and identify problem areas and perspectives.</p><p><strong>Methods: </strong>We first present the background of excursion diving and reference key procedures from the US Navy, Comex, and international standards. We then review the procedures of 13 anonymised diving companies and compare their sources, designs, and operation parameters.</p><p><strong>Results: </strong>The current excursion procedures are derived from a few original procedures (US Navy, Comex). It appears that, without relevant scientific support since the 1980s, companies have empirically adapted these procedures to their needs. Two designs prevail: excursions from storage depth and excursions from the deepest depth. Recent innovations offer 'standard' and 'extended' excursions, sliding excursion windows, as well as shallow and deep excursions. Companies participating in the study have a low risk of DCS with excursion diving. Excursions rarely produce immediate DCS symptoms but associated bubble formation could impact the final decompression. The trend is towards reduced excursion distances and explicit post-excursion intervals. Oxygen toxicity remains a general concern in saturation diving, but the PO₂ values used in the procedures reviewed are unlikely to cause pulmonary toxicity according to the dose models in use.</p><p><strong>Conclusions: </strong>We observed a trend towards harmonisation under the pressure of international standards and through cooperation within industry association committees. We recommend scientific monitoring of saturation divers to measure the decompression stress and support further research and development. We recommend that companies document their procedural developments to record and thus keep the lessons learned.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"21-40"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13095488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510220","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":"Liver disease and the Diver Medical Participant Questionnaire.","authors":"Andrew George Watson, Tiong Yeng Lim","doi":"10.28920/dhm56.1.95-96","DOIUrl":"10.28920/dhm56.1.95-96","url":null,"abstract":"","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"95-96"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510234","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":"Treatment success in relation to timing of hyperbaric oxygen therapy in idiopathic sudden sensorineural hearing loss.","authors":"Cheuk-Yin Lun, Kwan-Leong Au Yeung, Yuk-Fai Lau, Wing-Wa Yan, Kin-Bong Tang","doi":"10.28920/dhm56.1.41-47","DOIUrl":"10.28920/dhm56.1.41-47","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic sudden sensorineural hearing loss (ISSNHL) is an otologic emergency for which hyperbaric oxygen therapy (HBOT) is a potential treatment. This study aimed to evaluate the effectiveness of HBOT in treating ISSNHL, with a focus on the timing of treatment and its impact on hearing outcomes, while also considering other factors such as demographic characteristics, clinical parameters, and treatment methods.</p><p><strong>Methods: </strong>This retrospective cohort study analysed 70 ISSNHL patients (April 2019 to August 2024) who received steroid treatment (oral, intratympanic or both). Patients were divided into early HBOT (< 12 days), late HBOT (13-22 days), salvage HBOT (> 22 days), and no HBOT groups. Hearing improvement, measured by pure-tone audiometry (PTA), defined the treatment outcome.</p><p><strong>Results: </strong>Significant PTA improvements were observed in most groups (median changes: early HBOT 33.8 dB [n = 15], late HBOT 6.9 dB [n = 16], salvage HBOT 0.0 dB [n = 5], no HBOT 11.9 dB [n = 34]), with early HBOT showing greater gains than late HBOT (P < 0.001), salvage HBOT (P = 0.001), and no HBOT (P = 0.002). Receiver operating characteristic (ROC) analysis indicated that treatment within 10.5 days predicted marked improvement (AUC = 0.883, P < 0.001), and linear regression showed that each day's delay reduced PTA improvement by 0.832 dB (P < 0.001).</p><p><strong>Conclusions: </strong>HBOT is effective in restoring hearing in patients suffering from ISSNHL and early treatment is associated with better outcome.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"56 1","pages":"41-47"},"PeriodicalIF":1.3,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510214","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}