Diving and hyperbaric medicine最新文献_第6页

Pulmonary oxygen toxicity breath markers after heliox diving to 81 metres. 螺旋氧潜水至 81 米后的肺氧毒性呼吸标记。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.340-344

Feiko Jm de Jong, Paul Brinkman, Thijs T Wingelaar, Pieter-Jan Am van Ooij, Robert A van Hulst

{"title":"Pulmonary oxygen toxicity breath markers after heliox diving to 81 metres.","authors":"Feiko Jm de Jong, Paul Brinkman, Thijs T Wingelaar, Pieter-Jan Am van Ooij, Robert A van Hulst","doi":"10.28920/dhm53.4.340-344","DOIUrl":"10.28920/dhm53.4.340-344","url":null,"abstract":"Pulmonary oxygen toxicity (POT), an adverse reaction to an elevated partial pressure of oxygen in the lungs, can develop as a result of prolonged hyperbaric hyperoxic conditions. Initially starting with tracheal discomfort, it results in pulmonary symptoms and ultimately lung fibrosis. Previous studies identified several volatile organic compounds (VOCs) in exhaled breath indicative of POT after various wet and dry hyperbaric hypoxic exposures, predominantly in laboratory settings. This study examined VOCs after exposures to 81 metres of seawater by three navy divers during operational heliox diving. Univariate testing did not yield significant results. However, targeted multivariate analysis of POT-associated VOCs identified significant (P = 0.004) changes of dodecane, tetradecane, octane, methylcyclohexane, and butyl acetate during the 4 h post-dive sampling period. No airway symptoms or discomfort were reported. This study demonstrates that breath sampling can be performed in the field, and VOCs indicative of oxygen toxicity are exhaled without clinical symptoms of POT, strengthening the belief that POT develops on a subclinical-to-symptomatic spectrum. However, this study was performed during an actual diving operation and therefore various confounders were introduced, which were excluded in previous laboratory studies. Future studies could focus on optimising sampling protocols for field use to ensure uniformity and reproducibility, and on establishing dose-response relationships.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"340-344"},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801016","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

Comparing the EMMA capnograph with sidestream capnography and arterial carbon dioxide pressure at 284 kPa. 比较 EMMA 毛细血管通气记录仪与侧流毛细血管通气记录仪以及 284 千帕的动脉二氧化碳压力。

IF 0.9 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.327-332

Xavier Ce Vrijdag, Hanna van Waart, Chris Sames, Jamie W Sleigh, Simon J Mitchell

{"title":"Comparing the EMMA capnograph with sidestream capnography and arterial carbon dioxide pressure at 284 kPa.","authors":"Xavier Ce Vrijdag, Hanna van Waart, Chris Sames, Jamie W Sleigh, Simon J Mitchell","doi":"10.28920/dhm53.4.327-332","DOIUrl":"10.28920/dhm53.4.327-332","url":null,"abstract":"Introduction: Capnography aids assessment of the adequacy of mechanical patient ventilation. Physical and physiological changes in hyperbaric environments create ventilation challenges which make end-tidal carbon dioxide (ETCO2) measurement particularly important. However, obtaining accurate capnography in hyperbaric environments is widely considered difficult. This study investigated the EMMA capnograph for hyperbaric use.Methods: We compared the EMMA capnograph to sidestream capnography and the gold standard arterial carbon dioxide blood gas analysis in a hyperbaric chamber. In 12 resting subjects breathing air at 284 kPa, we recorded ETCO2 readings simultaneously derived from the EMMA and sidestream capnographs during two series of five breaths (total 24 measurements). An arterial blood gas sample was also taken simultaneously in five participants.Results: Across all measurements there was a difference of about 0.1 kPa between the EMMA and sidestream capnographs indicating a very slight over-estimation of ETCO2 by the EMMA capnograph, but fundamentally good agreement between the two end-tidal measurement methods. Compared to arterial blood gas pressure the non-significant difference was about 0.3 and 0.4 kPa for the EMMA and sidestream capnographs respectively.Conclusions: In this study, the EMMA capnograph performed equally to the sidestream capnograph when compared directly, and both capnography measures gave clinically acceptable estimates of arterial PCO2.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"327-332"},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801089","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 in delayed post-hypoxic encephalopathy following inhalation of liquefied petroleum gas: a case report. 吸入液化石油气后迟发性缺氧后脑病的高压氧治疗：病例报告。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.351-355

Kubra Canarslan Demir, Burak Turgut, Kubra Ozgok Kangal, Taylan Zaman, Kemal Şimşek

{"title":"Hyperbaric oxygen treatment in delayed post-hypoxic encephalopathy following inhalation of liquefied petroleum gas: a case report.","authors":"Kubra Canarslan Demir, Burak Turgut, Kubra Ozgok Kangal, Taylan Zaman, Kemal Şimşek","doi":"10.28920/dhm53.4.351-355","DOIUrl":"10.28920/dhm53.4.351-355","url":null,"abstract":"Delayed post-hypoxic encephalopathy can occur after an episode of anoxia or hypoxia. Symptoms include apathy, confusion, and neurological deficits. We describe a 47-year-old male patient who inhaled gas from a kitchen stove liquid petroleum gas cylinder. He was diagnosed with hypoxic ischaemic encephalopathy 12 hours after his emergency department admission. He received six sessions of hyperbaric oxygen treatment (HBOT) and was discharged in a healthy state after six days. Fifteen days later, he experienced weakness, loss of appetite, forgetfulness, depression, balance problems, and inability to perform self-care. One week later, he developed urinary and fecal incontinence and was diagnosed with post-hypoxic encephalopathy. After 45 days from the onset of symptoms, he was referred to the Underwater and Hyperbaric Medicine Department for HBOT. The patient exhibited poor self-care and slow speech rate, as well as ataxic gait and dysdiadochokinesia. Hyperbaric oxygen was administered for twenty-four sessions, which significantly improved the patient's neurological status with only hypoesthesia in the left hand remaining at the end of treatment. Hyperbaric oxygen has been reported as successful in treating some cases of delayed neurological sequelae following CO intoxication. It is possible that HBO therapy may also be effective in delayed post-hypoxic encephalopathy from other causes. This may be achieved through mechanisms such as transfer of functional mitochondria to the injury site, remyelination of damaged neurons, angiogenesis and neurogenesis, production of anti-inflammatory cytokines, and balancing of inflammatory and anti-inflammatory cytokines.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"351-355"},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801099","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

Full-face snorkel masks increase the incidence of hypoxaemia and hypercapnia during simulated snorkelling compared to conventional snorkels. 与传统呼吸管相比，全脸呼吸管面罩会增加模拟呼吸过程中低氧血症和高碳酸血症的发生率。

IF 0.9 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.313-320

Janneke Grundemann, Xavier Ce Vrijdag, Nicole Ye Wong, Nicholas Gant, Simon J Mitchell, Hanna van Waart

{"title":"Full-face snorkel masks increase the incidence of hypoxaemia and hypercapnia during simulated snorkelling compared to conventional snorkels.","authors":"Janneke Grundemann, Xavier Ce Vrijdag, Nicole Ye Wong, Nicholas Gant, Simon J Mitchell, Hanna van Waart","doi":"10.28920/dhm53.4.313-320","DOIUrl":"10.28920/dhm53.4.313-320","url":null,"abstract":"Introduction: Air flow in full-face snorkel masks (FFSMs) should be unidirectional to prevent rebreathing of exhaled air. This study evaluated rebreathing and its consequences when using FFSMs compared to a conventional snorkel.Methods: In a dry environment 20 participants wore three types of snorkel equipment in random order: Subea Easybreath FFSM; QingSong 180-degree panoramic FFSM; and a Beuchat Spy conventional snorkel (with nose clip), in three conditions: rest in a chair; light; and moderate intensity exercise on a cycle ergometer. Peripheral oxygen saturation, partial pressure of carbon dioxide (PCO2) and oxygen (PO2) in the end tidal gas and FFSM eye-pockets, respiratory rate, minute ventilation, were measured continuously. Experiments were discontinued if oxygen saturation dropped below 85%, or if end-tidal CO2 exceeded 7.0 kPa.Results: Experimental runs with the FFSMs had to be discontinued more often after exceeding 7.0 kPa end-tidal CO2 compared to a conventional snorkel e.g., 18/40 (45%) versus 4/20 (20%) during light intensity exercise, and 9/22 (41%) versus 3/16 (19%) during moderate intensity exercise. Thirteen participants exhibited peripheral oxygen saturations below 95% (nine using FFSMs and four using the conventional snorkel) and five fell below 90% (four using FFSMs and one using the conventional snorkel). The PCO2 and PO2 in the eye-pockets of the FFSMs fluctuated and were significantly higher and lower respectively than in inspired gas, which indicated rebreathing in all FFSM wearers.Conclusions: Use of FFSMs may result in rebreathing due to non-unidirectional flow, leading to hypercapnia and hypoxaemia.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"313-320"},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801096","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

University of Auckland Postgraduate Diploma in Diving and Hyperbaric Medicine. 奥克兰大学潜水和高压氧医学研究生文凭。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.360

Michael Davis

引用次数: 0

Hypoxic loss of consciousness in air diving: two cases of mixtures made hypoxic by oxidation of the scuba diving cylinder. 空气潜水中的缺氧性意识丧失：两个因潜水气瓶氧化而导致混合物缺氧的案例。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.356-359

Arnaud Druelle, Lucille Daubresse, Jean U Mullot, Hélène Streit, Pierre Louge

引用次数: 0

Cerebral arterial gas embolism (CAGE) during open water scuba certification training whilst practising a controlled emergency swimming ascent. 在开放水域水肺认证培训中，在练习受控紧急游泳上升时发生脑动脉气体栓塞 (CAGE)。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.345-350

Neil Banham, Elisabete da Silva, John Lippmann

引用次数: 0

A European code of good practice for hyperbaric oxygen therapy - Review 2022. 欧洲高压氧治疗良好操作规范--2022 年回顾。

IF 0.9 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.suppl.1-17

Jacek Kot, Jordi Desola, Folke Lind, Peter Mueller, Erik Jansen, Francois Burman, - Working Group

引用次数: 0

Rapture of the deep: gas narcosis may impair decision-making in scuba divers. 深海狂喜：气体麻醉可能会影响水肺潜水员的决策。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.306-312

Pauliina A Ahti, Jan Wikgren

{"title":"Rapture of the deep: gas narcosis may impair decision-making in scuba divers.","authors":"Pauliina A Ahti, Jan Wikgren","doi":"10.28920/dhm53.4.306-312","DOIUrl":"10.28920/dhm53.4.306-312","url":null,"abstract":"Introduction: While gas narcosis is familiar to most divers conducting deep (> 30 metres) dives, its effects are often considered minuscule or subtle at 30 metres. However, previous studies have shown that narcosis may affect divers at depths usually considered safe from its influence, but little knowledge exists on the effects of gas narcosis on higher cognitive functions such as decision-making in relatively shallow water at 30 metres. Impaired decision-making could be a significant safety issue for a multitasking diver.Methods: We conducted a study exploring the effects of gas narcosis on decision-making in divers breathing compressed air underwater. The divers (n = 22) were evenly divided into 5-metre and 30-metre groups. In the water, we used underwater tablets equipped with the Iowa Gambling Task (IGT), a well-known psychological task used to evaluate impairment in decision-making.Results: The divers at 30 metres achieved a lower score (mean 1,584.5, standard deviation 436.7) in the IGT than the divers at 5 metres (mean 2,062.5, standard deviation 584.1). Age, body mass index, gender, or the number of previous dives did not affect performance in the IGT.Conclusions: Our results suggest that gas narcosis may affect decision-making in scuba divers at 30 metres depth. This supports previous studies showing that gas narcosis is present at relatively shallow depths and shows that it may affect higher cognitive functions.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"306-312"},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801017","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

Within-diver variability in venous gas emboli (VGE) following repeated dives. 多次潜水后静脉气体栓塞（VGE）在潜水员内部的变化。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.333-339

David J Doolette, F Gregory Murphy

{"title":"Within-diver variability in venous gas emboli (VGE) following repeated dives.","authors":"David J Doolette, F Gregory Murphy","doi":"10.28920/dhm53.4.333-339","DOIUrl":"10.28920/dhm53.4.333-339","url":null,"abstract":"Introduction: Venous gas emboli (VGE) are widely used as a surrogate endpoint instead of decompression sickness (DCS) in studies of decompression procedures. Peak post-dive VGE grades vary widely following repeated identical dives but little is known about how much of the variability in VGE grades is proportioned between-diver and within-diver.Methods: A retrospective analysis of 834 man-dives on six dive profiles with post-dive VGE measurements was conducted under controlled laboratory conditions. Among these data, 151 divers did repeated dives on the same profile on two to nine occasions separated by at least one week (total of 693 man-dives). Data were analysed for between- and within-diver variability in peak post-dive VGE grades using mixed-effect models with diver as the random variable and associated intraclass correlation coefficients.Results: Most divers produced a wide range of VGE grades after repeated dives on the same profile. The intraclass correlation coefficient (repeatability) was 0.33 indicating that 33% of the variability in VGE grades is between-diver variability; correspondingly, 67% of variability in VGE grades is within-diver variability. DCS cases were associated with an individual diver's highest VGE grades and not with their lower VGE grades.Conclusions: These data demonstrate large within-diver variability in VGE grades following repeated dives on the same dive profile and suggest there is substantial within-diver variability in susceptibility to DCS. Post-dive VGE grades are not useful for evaluating decompression practice for individual divers.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"333-339"},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801026","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