Diving and hyperbaric medicine最新文献_第8页

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

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

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 0.8 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 Working Group

引用次数: 0

Diving with psychotropic medication: review of the literature and clinical considerations. 精神药物潜水：文献综述和临床注意事项。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.259-267

Abraham L Querido, Chiel F Ebbelaar, Thijs T Wingelaar

引用次数: 0

Investigation into the effect of hyperbaric hyperoxia on serum cardiac Troponin T levels as a biomarker of cardiac injury. 高压氧对作为心脏损伤生物标志物的血清心肌肌钙蛋白T水平影响的研究。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.281-284

Jack Marjot, John Mackenzie, Nigel Jepson, Ewan Reeves, Michael Bennett

{"title":"Investigation into the effect of hyperbaric hyperoxia on serum cardiac Troponin T levels as a biomarker of cardiac injury.","authors":"Jack Marjot, John Mackenzie, Nigel Jepson, Ewan Reeves, Michael Bennett","doi":"10.28920/dhm53.3.281-284","DOIUrl":"10.28920/dhm53.3.281-284","url":null,"abstract":"Introduction: There is clinical equipoise as to whether hyperoxia is injurious to the myocardium, both in the setting of acute ischaemic insults and on the stable myocardium. This study examined the effect of extreme hyperoxia - in the form of hyperbaric oxygen treatment - on the myocardium through measurement of high-sensitivity cardiac troponin.Methods: Forty-eight individuals were enrolled to undergo a series of 30 exposures to hyperbaric oxygen for treatment of non-cardiac pathologies. High-sensitivity troponin T was measured before and after each session.Results: There was no clinically significant difference in troponin measurements following acute or recurrent sequential exposures to extreme hyperoxia, despite the studied patient population having a high rate of previous ischaemic heart disease or cardiovascular risk factors.Conclusions: This study demonstrates that profound hyperoxaemia does not induce any measurable cardiac injury at a biochemical level. Neither is there a reduction in cardiac troponin to suggest a cardioprotective effect of hyperbaric hyperoxia. This provides some reassurance as to the cardiac safety of the routine use of hyperbaric oxygen treatment in management of non-cardiac pathology.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"281-284"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299458","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

An evaluation of the NUI Compact Chest Compression Device (NCCD), a mechanical CPR device suitable for use in the saturation diving environment. NUI紧凑型胸部按压装置（NCCD）的评估，这是一种适用于饱和潜水环境的机械CPR装置。

IF 0.9 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.181-188

Andrew Tabner, Philip Bryson, Nicholas Tilbury, Benjamin McGregor, Alistair Wesson, Gareth D Hughes, Gareth R Hughes, Graham Johnson

{"title":"An evaluation of the NUI Compact Chest Compression Device (NCCD), a mechanical CPR device suitable for use in the saturation diving environment.","authors":"Andrew Tabner, Philip Bryson, Nicholas Tilbury, Benjamin McGregor, Alistair Wesson, Gareth D Hughes, Gareth R Hughes, Graham Johnson","doi":"10.28920/dhm53.3.181-188","DOIUrl":"10.28920/dhm53.3.181-188","url":null,"abstract":"Introduction: Provision of manual chest compressions in a diving bell using a conventional technique is often impossible, and alternative techniques are poorly evidenced in terms of efficacy and sustainability. The first mechanical cardiopulmonary resuscitation (CPR) device suitable for use in this environment, the NUI Compact Chest Compression Device (NCCD), has recently been designed and manufactured. This study assessed both the efficacy of the device in delivering chest compressions to both prone and seated manikins, and the ability of novice users to apply and operate it.Methods: Compression efficacy was assessed using a Resusi Anne QCPR intelligent manikin, and the primary outcome was the proportion of compressions delivered to target depth (50-60 mm). The gold standard was that achieved by expert CPR providers delivering manual CPR; the LUCAS 3 mCPR device was a further comparator.Results: The NCCD delivered 100% of compressions to target depth compared to 98% for the gold standard (interquartile range 1.5%) and 98% for the LUCAS 3 when applied to both supine and seated manikins. The NCCD sometimes became dislodged and had to be reapplied when used with a seated manikin.Conclusions: The NCCD can deliver chest compressions at target rate and depth to both supine and seated manikins with efficacy equivalent to manual CPR and the LUCAS 3. It can become dislodged when applied to a seated manikin; its design has now been altered to prevent this. New users can be trained in use of the NCCD quickly, but practise is required to ensure effective use.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"181-188"},"PeriodicalIF":0.9,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10597600/pdf/DHM-53-181.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306275","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

Self-reported vitality and health status are higher in Dutch submariners than in the general population. 荷兰潜艇艇员自我报告的活力和健康状况高于普通人群。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.218-223

Antoinette Houtkooper, Thijs T Wingelaar, Edwin L Endert, Pieter-Jan Am van Ooij

{"title":"Self-reported vitality and health status are higher in Dutch submariners than in the general population.","authors":"Antoinette Houtkooper, Thijs T Wingelaar, Edwin L Endert, Pieter-Jan Am van Ooij","doi":"10.28920/dhm53.3.218-223","DOIUrl":"10.28920/dhm53.3.218-223","url":null,"abstract":"Introduction: Living aboard submarines has a potential negative effect on health. Although studies have evaluated specific health hazards and short-term outcomes, long-term health effects have not been investigated in this population.Methods: Veteran submariners were contacted through the veterans' society and administered a World Health Organisation validated questionnaire (SF-36) assessing their physical, emotional, and social functioning. Scores were compared with those of the general (reference) population and scores in veteran submariners were differentiated by rank, time at sea and time in service. Statistical analyses were performed using the Wilcoxon signed rank and Kruskal-Wallis tests.Results: Of the 1,025 submariners approached in December 2019, 742 (72.4%) completed and returned the questionnaire before July 2020. All 742 were men, of median age 68 (interquartile range [IQR] 59-76) years (range 34-99 years). Of these subjects, 10.3% were current smokers, 64.4% were former smokers and 23.7% had never smoked. Submariners scored significantly better (P < 0.001) than the general population on all eight domains of the SF-36. Except for 'pain' and 'change in health status over the last year', scores for all domains decreased with age. Scores were not significantly affected by smoking status, rank, service, and time at sea.Conclusions: Dutch veteran submariners have better self-reported vitality and health status than the general Dutch population. Rank, service, and time at sea did not significantly affect scores of Dutch submariners.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"218-223"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306277","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

Delivering manual cardiopulmonary resuscitation (CPR) in a diving bell: an analysis of head-to-chest and knee-to-chest compression techniques. 在潜水钟中进行人工心肺复苏术（CPR）：头到胸部和膝盖到胸部按压技术的分析。

IF 0.9 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.172-180

Graham Johnson, Philip Bryson, Nicholas Tilbury, Benjamin McGregor, Alistair Wesson, Gareth D Hughes, Gareth R Hughes, Andrew Tabner

{"title":"Delivering manual cardiopulmonary resuscitation (CPR) in a diving bell: an analysis of head-to-chest and knee-to-chest compression techniques.","authors":"Graham Johnson, Philip Bryson, Nicholas Tilbury, Benjamin McGregor, Alistair Wesson, Gareth D Hughes, Gareth R Hughes, Andrew Tabner","doi":"10.28920/dhm53.3.172-180","DOIUrl":"10.28920/dhm53.3.172-180","url":null,"abstract":"Introduction: Chest compression often cannot be administered using conventional techniques in a diving bell. Multiple alternative techniques are taught, including head-to-chest and both prone and seated knee-to-chest compressions, but there are no supporting efficacy data. This study evaluated the efficacy, safety and sustainability of these techniques.Methods: Chest compressions were delivered by a team of expert cardiopulmonary resuscitation (CPR) providers. The primary outcome was proportion of chest compressions delivered to target depth compared to conventional CPR. Techniques found to be safe and potentially effective by the study team were further trialled by 20 emergency department staff members.Results: Expert providers delivered a median of 98% (interquartile range [IQR] 1.5%) of chest compressions to the target depth using conventional CPR. Only 32% (IQR 60.8%) of head-to-chest compressions were delivered to depth; evaluation of the technique was abandoned due to adverse effects. No study team member could register sustained compression outputs using prone knee-to-chest compressions. Seated knee-to-chest were delivered to depth 12% (IQR 49%) of the time; some compression providers delivered > 90% of compressions to depth.Conclusions: Head-to-chest compressions have limited efficacy and cause harm to providers; they should not be taught or used. Prone knee-to-chest compressions are ineffective. Seated knee-to-chest compressions have poor overall efficacy but some providers deliver them well. Further research is required to establish whether this technique is feasible, effective and sustainable in a diving bell setting, and whether it can be taught and improved with practise.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"172-180"},"PeriodicalIF":0.9,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10597601/pdf/DHM-53-172.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10310532","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 children: experience in 329 patients. 329例儿童高压氧治疗经验。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.203-209

Figen Aydin

{"title":"Hyperbaric oxygen treatment in children: experience in 329 patients.","authors":"Figen Aydin","doi":"10.28920/dhm53.3.203-209","DOIUrl":"10.28920/dhm53.3.203-209","url":null,"abstract":"Introduction: Paediatric patients, like adults, may undergo hyperbaric oxygen treatment (HBOT) in both life-threatening situations and chronic diseases. There are particular challenges associated with managing paediatric patients for HBOT. This paper documents the indications, results, complications, and difficulties that occur during HBOT for a large cohort of paediatric patients and compares them with adult data in the literature. Methods used to reduce these difficulties and complications in children are also discussed.Methods: This was a 15-year retrospective review of paediatric patients treated with HBOT at two hyperbaric centres. Between January 2006 and June 2021, patients under the age of 18 who received at least one session of HBOT were included.Results: Three hundred and twenty-nine paediatric patients underwent a total of 3,164 HBOT exposures. Two-hundred and fifty-four patients (77.2%) completed treatment as planned and 218 (66.5%) achieved treatment goals without complications. Two patients treated for carbon monoxide poisoning exhibited neurological sequelae. Amputation was performed in one patient with limb ischaemia. Middle ear barotrauma events occurred in five treatments. No central nervous system oxygen toxicity was recorded during the treatments.Conclusions: This patient series indicates that HBOT can be safely performed in pediatric patients with low complication rates by taking appropriate precautions. The cooperation of hyperbaric medicine physicians and other physicians related to paediatric healthcare is important in order for more patients to benefit from this treatment. When managing intubated patients an anaesthesiologist may need to participate in the treatment in order to perform necessary interventions.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"203-209"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306278","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