Diving and hyperbaric medicine最新文献

{"title":"Hyperbaric oxygen therapy for late onset dropped head syndrome following mantle field radiation therapy for Hodgkin lymphoma: a case report and literature review.","authors":"Shane A Rosenzweig, Stephen R Thompson, Michael H Bennett","doi":"10.28920/dhm55.3.275-279","DOIUrl":"10.28920/dhm55.3.275-279","url":null,"abstract":"<p><p>The authors present the first documented case of the apparent effective use of hyperbaric oxygen therapy (HBOT) for the treatment of radiation-induced dropped head syndrome (DHS). DHS is a condition associated with progressive and often severe weakness of cervical paraspinal muscles, especially the neck extensors. This results in loss of horizontal gaze and in advanced cases causes a chin-on-chest deformity. Radiation-induced DHS is a rare, primarily late-term complication first described in patients treated with mantle field radiotherapy for Hodgkin lymphoma, though there is an increasing body of literature demonstrating a wide range of presentations. A 59-year-old man with a history of stage 2A Hodgkin lymphoma 34 years prior had been treated with extended field radiotherapy, including mantle radiotherapy, totalling 40 Gy in 19 fractions. He presented with three years of progressive neck extension weakness with associated stiffness and intermittent dysphagia. The patient underwent 60 sessions of HBOT, in conjunction with physiotherapy and thiamine replacement and demonstrated improvement of his postural maintenance and dysphagia. His improved function was maintained at three years follow-up. We discuss the literature on the management of this rare condition, including the rationale for using HBOT which is well documented for the treatment of other late-term radiotherapy side effects. This case adds to the increasing literature on the management of DHS and describes a novel approach to the management of this often-debilitating condition.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"275-279"},"PeriodicalIF":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130362","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":"Revised guideline for central nervous system oxygen toxicity exposure limits when using an inspired PO2 of 1.3 atmospheres.","authors":"Joseph T Hoyt, F Gregory Murphy, Neal W Pollock, Dawn Kernagis, Nicholas Bird, Michael Menduno, John Bright, Simon J Mitchell","doi":"10.28920/dhm55.3.262-270","DOIUrl":"10.28920/dhm55.3.262-270","url":null,"abstract":"<p><p>Technical and scientific divers breathing gases delivering hyperbaric pressures of inspired oxygen may be at risk of developing cerebral oxygen toxicity which can manifest as a seizure with little or no warning. The principle preventative strategy is adherence to time limits based on inspired PO₂ levels promulgated in 1991. These limits had their origins in US Navy studies of exposures to higher inspired PO₂s than are typically utilised by modern divers. Indeed, the duration limits for inspired PO₂s in the range typically utilised by technical divers (≤ 1.3-1.4 atm) have relatively little experimental provenance. Contemporary technical dives often involve decompression durations that result in breaches of these limits, and anecdotally, this common occurrence seems associated with a low risk of cerebral oxygen toxicity. A committee of experts recently sought experimental evidence that might support an adjustment to the recommended duration limits for typical technical dives. Such evidence exists only for an inspired PO₂ of 1.3 atm, which is a common default in use of constant PO₂ rebreather devices. The (1991) limit for a single exposure to an inspire PO₂ of 1.3 atm is 180 min with a 24-hour maximum of 210 min. Recent studies provide reassurance that dives with an inspired PO₂ of 1.3 atm consisting of up to 240 min of working dive activity followed by up to 240 min of resting decompression are associated with an acceptably low risk of cerebral oxygen toxicity. This recommendation was promulgated and endorsed at a recent workshop convened by the National Oceanographic and Atmospheric Administration (NOAA) involving technical and scientific divers.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"55 3","pages":"262-270"},"PeriodicalIF":1.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130278","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":"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":1.3,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12790927/pdf/","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":"OA","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":1.3,"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":"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":1.3,"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":"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":1.3,"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":"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":1.3,"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":1.1,"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":1.3,"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":"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":1.3,"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}