Diving and hyperbaric medicine最新文献_第5页

The process, logistics and governance behind a high-stakes novel intervention: the use of extracorporeal membrane oxygenation (ECMO) in the hyperbaric chamber. 高风险新干预措施背后的过程、后勤和治理：在高压氧室中使用体外膜氧合（ECMO）。

IF 1.1 4区医学

Diving and hyperbaric medicine Pub Date : 2025-12-20 DOI: 10.28920/dhm55.4.315-322

Brandon Adams, Adele Templeton, Theo Tsouras, Jayne Sheldrake, Lloyd Roberts, Zhiliang Caleb Lin, Ian Millar, Judit Orosz, Tania Birthisel, Bridget Devaney

{"title":"The process, logistics and governance behind a high-stakes novel intervention: the use of extracorporeal membrane oxygenation (ECMO) in the hyperbaric chamber.","authors":"Brandon Adams, Adele Templeton, Theo Tsouras, Jayne Sheldrake, Lloyd Roberts, Zhiliang Caleb Lin, Ian Millar, Judit Orosz, Tania Birthisel, Bridget Devaney","doi":"10.28920/dhm55.4.315-322","DOIUrl":"10.28920/dhm55.4.315-322","url":null,"abstract":"Introduction: A multi-trauma patient receiving extracorporeal membrane oxygenation (ECMO) developed severe disseminated vaso-invasive fungal disease. In the absence of any remaining treatment escalation options, hyperbaric oxygen treatment (HBOT) was considered as a last effort at gaining disease control. Previously, the use of modern ECMO devices had not been validated for hyperbaric use at our centre or, to the best of our knowledge, at any other centre around the world. We had, however, identified a potentially hyperbaric compatible ECMO device and had commenced a validation process. The aim of this report is to highlight the practical, operational and governance processes undertaken to safely provide HBOT utilising ECMO at short notice.Methods: A detailed risk assessment, development of risk reduction strategies and workflows, emergency out-of-session ethics review, clinical innovations committee review, legal advice, executive approvals and informed consent were undertaken over a 32-hour period prior to commencing HBOT.Results: We present the identified risks, governance approvals, workflow, staffing model, chamber layout and safety checklist utilised to successfully deliver thirteen HBOT sessions to a patient on venovenous (VV) ECMO.Conclusions: Through an extensive and coordinated effort involving multiple specialties and disciplines at our service, we were able to safely deliver HBOT to a patient supported by VV ECMO.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 4","pages":"315-322"},"PeriodicalIF":1.1,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12823154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713773","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 therapy for hypoglycaemic encephalopathy due to insulinoma: a case report. 高压氧治疗胰岛素瘤所致低血糖性脑病1例报告。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-12-20 DOI: 10.28920/dhm55.4.430-433

Haitao Chu, Xiuchun Zhang, Hang Zhao, Xin Meng, Danna Wang, Yang Wang

引用次数: 0

The role and efficacy of ECG screening in assessing fitness to dive in military divers: implications of sports medicine standards. 心电图筛查在评估军事潜水员潜水能力中的作用和功效：运动医学标准的意义。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.246-253

Bas L van der Kooi, Alef Dm Hoedemaeker, Lysette N Broekhuizen, Pieter-Jan Am van Ooij, Thijs T Wingelaar

{"title":"The role and efficacy of ECG screening in assessing fitness to dive in military divers: implications of sports medicine standards.","authors":"Bas L van der Kooi, Alef Dm Hoedemaeker, Lysette N Broekhuizen, Pieter-Jan Am van Ooij, Thijs T Wingelaar","doi":"10.28920/dhm55.3.246-253","DOIUrl":"10.28920/dhm55.3.246-253","url":null,"abstract":"Introduction: Diving necessitates significant physiological adaptations, particularly within the cardiopulmonary system. Resting electrocardiograms (ECGs) are widely used in fitness to dive assessments, but their effectiveness in healthy young divers remains unclear. This study assessed the impact of applying sports medicine ECG criteria compared to traditional clinical standards, aiming to reduce (unnecessary) referrals to a cardiologist without compromising diver safety.Methods: In this retrospective study covering 10 years, ECGs from Royal Netherlands Navy divers were analysed. Abnormal ECGs identified by clinical criteria between 2010 and 2019 were re-evaluated using international sports medicine ECG criteria. A control group of normal ECGs was matched based on demographic factors. Statistical analyses were performed using Pearson's chi-squared and Fisher's exact test, with significance set at P < 0.05.Results: Of a total of 3,020 ECGs, 156 were classified as abnormal by clinical criteria. Reassessment using sports medicine standards reduced the number requiring further investigation by 85.9%. In the control group, 1.0% of previously unremarkable ECGs were identified as requiring further investigation upon reassessment. Conduction disorders and rhythm disturbances were the most common findings.Conclusions: The findings of this study suggest that the application of sports medicine ECG interpretation criteria effectively reduces the number of ECGs requiring further investigation, thereby minimising referrals and associated costs. These results advocate for a re-evaluation of routine ECG screening practices in fitness to dive assessments in military divers, promoting a more tailored approach for this specific group.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"246-253"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130361","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

The effect of hyperbaric oxygen therapy on lesion size in early-stage femoral head avascular necrosis. 高压氧治疗对早期股骨头缺血性坏死病灶大小的影响。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.226-230

Mehmet Ekici, Eyüp Can Mazlum, Mahmut Burak Laçin, Mehmet Emin Akçin, Ali Eray Günay, Firat Ozan

{"title":"The effect of hyperbaric oxygen therapy on lesion size in early-stage femoral head avascular necrosis.","authors":"Mehmet Ekici, Eyüp Can Mazlum, Mahmut Burak Laçin, Mehmet Emin Akçin, Ali Eray Günay, Firat Ozan","doi":"10.28920/dhm55.3.226-230","DOIUrl":"10.28920/dhm55.3.226-230","url":null,"abstract":"Introduction: Femoral head avascular necrosis (AVN) is a common orthopaedic condition that occurs when intraosseous microcirculation is compromised. Hyperbaric oxygen therapy (HBOT) increases tissue oxygen concentration, reduces oedema, stimulates angiogenesis, lowers intraosseous pressure, and enhances microcirculation. The aim of this study was to evaluate the effectiveness of HBOT in early femoral head AVN based on magnetic resonance imaging (MRI) findings.Methods: A total of 37 hips from 25 patients with Ficat Stage 1-2 femoral head AVN, followed between 2018 and 2021 and receiving HBOT at Kayseri City Training and Research Hospital, were retrospectively included. Thirty HBOT sessions of 90 minutes each were administered at 243 kPa pressure (2.4 atmospheres absolute) with 100% oxygen breathing, along with a weight-bearing restriction protocol.Results: There were 20 females and five males. The mean (standard deviation) age was 46.9 (9.5). In pre-treatment MRI imaging, the mean lesion size was 29.87 (22.64) cm³ in 20 right hips and 28.84 (14.95) cm³ in 17 left hips (P = 0.183). At the second month after treatment, the lesion size was 12.39 (11.26) cm³ in 20 right hips and 21.81 (13.56) cm³ in 17 left hips (P < 0.001). The mean pre-post differences for the right and left hips was 17.48 (21.15) cm³ and 7.02 (5.95) cm3 respectively (both P < 0.001).Conclusions: Femoral head AVN is a progressive disease, with femoral head collapse exceeding 40% in a five-year follow-up. This study demonstrated a reduction in lesion size associated with HBOT in early stage femoral head AVN. In our opinion, HBOT is an integral part of the treatment for early-stage femoral avascular necrosis.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"226-230"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130290","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

Assessing dive fitness in individuals with autism spectrum disorder. 评估自闭症谱系障碍个体的潜水适应性。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.254-261

Abraham L Querido, Thijs T Wingelaar

{"title":"Assessing dive fitness in individuals with autism spectrum disorder.","authors":"Abraham L Querido, Thijs T Wingelaar","doi":"10.28920/dhm55.3.254-261","DOIUrl":"10.28920/dhm55.3.254-261","url":null,"abstract":"Scuba diving requires situational awareness, cognitive flexibility, and the ability to adapt to changing conditions. For individuals with autism spectrum disorder (ASD), these demands may pose unique challenges due to differences in executive functioning, sensory processing, and social cognition. This article explores the key considerations in assessing fitness to dive in individuals with ASD, including the impact of comorbidities, medication use, and cognitive abilities on diving safety. To provide a broader perspective, we examine research on ASD and high-risk activities such as driving, where similar cognitive and decision-making challenges exist. Additionally, we discuss the role of neuropsychological assessments in evaluating a diver's cognitive fitness and the limited but emerging evidence on scuba diving interventions for individuals with ASD. While ASD is not an absolute contraindication to diving, a careful, individualised assessment is essential to determine suitability. This review aims to provide guidance for diving professionals and medical examiners in making informed decisions regarding ASD and scuba diving.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"254-261"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130346","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

Localised tissue necrosis from marine puncture injury: first aid, definitive management and review of the literature. 海洋穿刺损伤引起的局部组织坏死：急救、最终处理和文献回顾。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.289-293

Deon A Viljoen, Jessica Andrews

引用次数: 0

Evaluation of bacterial survival on inert surfaces in a hyperbaric environment. 在高压环境中细菌在惰性表面存活的评估。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.231-235

Laetitia Hendier, Hervé Soule, Mohamed Abbas, Didier Pittet, Rodrigue Pignel, Sylvain Boet

{"title":"Evaluation of bacterial survival on inert surfaces in a hyperbaric environment.","authors":"Laetitia Hendier, Hervé Soule, Mohamed Abbas, Didier Pittet, Rodrigue Pignel, Sylvain Boet","doi":"10.28920/dhm55.3.231-235","DOIUrl":"10.28920/dhm55.3.231-235","url":null,"abstract":"Introduction: Surface cleaning and hand hygiene within hyperbaric chambers are challenging because of the risk of fire with currently used products containing alcohol or glycerine. This study aimed to investigate if hyperbaric conditions could have inhibitory effects on bacteria present on inert materials.Methods: We deposited Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) on inert materials in an experimental chamber (Comex1200Alu) and compressed the chamber environment with air (253 kPa, 95 minutes) (referred to as indoor). The control was contaminated materials placed outside the chamber (referred to as outdoor). We chose inert materials including plastic, metal, and seat upholstery (imitation leather). We measured bacterial growth and survival and compared the groups using a Student's t-test.Results: Regardless of the surface types tested, there were no significant differences in bacterial reduction between indoor and outdoor conditions for either E. coli or S. aureus and any of the materials (P > 0.05).Conclusions: We found that pressurised air (253 kPa for 95 minutes) has neither proliferative nor bactericidal action on S. aureus and E. coli colonies deposited on inert surfaces compared to those present outside a hyperbaric chamber in normobaric air conditions.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"231-235"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130322","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

Periorbital emphysema after a dry hyperbaric chamber exposure. 干高压氧室暴露后的眶周肺气肿。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.280-283

Ping Wu, Kin Bong Tang, Wing Wa Yan

引用次数: 0

Serial chest computed tomography imaging in a freediver with a case of pulmonary barotrauma of descent (lung squeeze) showing the time course of resolution. 连续胸部计算机断层成像显示一个自由潜水员的肺下降气压损伤（肺挤压）的时间过程。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.271-274

Madeleine E Wagner, Elaine Yu, Anna Lussier, Nicole Lin, Henry Guo, Peter Lindholm

{"title":"Serial chest computed tomography imaging in a freediver with a case of pulmonary barotrauma of descent (lung squeeze) showing the time course of resolution.","authors":"Madeleine E Wagner, Elaine Yu, Anna Lussier, Nicole Lin, Henry Guo, Peter Lindholm","doi":"10.28920/dhm55.3.271-274","DOIUrl":"10.28920/dhm55.3.271-274","url":null,"abstract":"Freedivers can suffer respiratory symptoms indicative of freediving induced pulmonary syndrome (FIPS). Aetiology includes immersion pulmonary oedema and barotrauma of descent in the tracheobronchial or pulmonary parenchyma, also colloquially called 'squeeze'. The pathophysiology and natural history are still largely unknown. This case report describes a freediver who developed haemoptysis following a 49 m personal best constant weight bi-fin dive, presenting with two episodes of haemoptysis within 24 hours post-dive. This style of diving entails finning down to the desired depth, turning with a single pull on the rope, and then finning up to the surface without use of the arms. The diver exhibited no other symptoms and remained haemodynamically stable. Computed tomography (CT) imaging performed two days post-dive showed ground-glass opacities in the right upper and middle lobes. Treatment involved hospitalisation, high-dose corticosteroids, and antibiotics. Follow-up CT scans post-dive revealed almost complete resolution (six days) followed by complete resolution of pulmonary abnormalities (21 days). This case is unique for its documentation of changes in lung findings over three sequential CT scans, providing a timeline of anatomical recovery. Serial CT scanning would not be routinely recommended from a radiation safety perspective but yielded interesting data into the time course of this trauma. The findings raise questions about the underdiagnosis of squeeze injuries, as this diver displayed minimal symptoms despite radiographic evidence of ground-glass opacities. This case highlights the need for standardised imaging and management protocols, as well as further research into the natural history and clinical significance of FIPS.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"271-274"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130265","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

Vestibular rehabilitation and recovery in divers with inner ear decompression sickness: a case series. 潜水员内耳减压病的前庭康复和恢复：一个病例系列。

IF 1.3 4区医学

Diving and hyperbaric medicine Pub Date : 2025-09-30 DOI: 10.28920/dhm55.3.236-245

Rosanna J Stokes, Doug Watts, Gary Smerdon, Stephen D Hall, Lisa Bunn, Jonathan Marsden

{"title":"Vestibular rehabilitation and recovery in divers with inner ear decompression sickness: a case series.","authors":"Rosanna J Stokes, Doug Watts, Gary Smerdon, Stephen D Hall, Lisa Bunn, Jonathan Marsden","doi":"10.28920/dhm55.3.236-245","DOIUrl":"10.28920/dhm55.3.236-245","url":null,"abstract":"Introduction: The mechanism of injury and recovery of divers with inner ear decompression sickness (IEDCS) is not well understood and there is no consensus regarding management following recompression treatment. Given the rare occurrence, divers are not routinely offered the standard therapies that patients with other acute vestibular disorders may be offered such as vestibular rehabilitation.Methods: This is an observational case series of 13 divers presenting acutely with IEDCS to DDRC Healthcare in Plymouth, UK between July 2021 and January 2024. Vestibular and balance tests were undertaken to aid the treating dive physician in the diagnosis and management of the divers with both hyperbaric oxygen therapy and customised vestibular rehabilitation.Results: Average values for vertical perception, posturography, dynamic gait index and patient-reported outcomes measures improved by discharge and at the three month follow up despite 67% showing an ongoing positive head impulse test or nystagmus in the dark on videonystagmography at follow up.Conclusions: Divers should be warned that despite symptom resolution or minimal residual symptoms post-IEDCS there is a high rate of deficit evident on vestibular testing, and this, alongside investigation for a right to left cardiac shunt, should be a major consideration when considering returning to diving. For the clinician, a stopwatch timed Sharpened Romberg's test appears to be a reasonable method for monitoring progress of balance stabilisation during the treatment period. Early initiation of vestibular rehabilitation exercises should be considered for all divers with IEDCS.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"236-245"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130418","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