Undersea and Hyperbaric Medicine最新文献

{"title":"Laptop-style point-of-care ultrasound machines in the multiplace hyperbaric oxygen treatment chamber.","authors":"Jenny Thacker, Marc Pullis, Thomas Masters, Christopher Logue","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Point-of-care ultrasound (POCUS) has diverse uses in the critical care hyperbaric (HBO₂) environment. The use of electronic devices in a multiplace HBO₂ chamber has traditionally been limited secondary to fire risk.</p><p><strong>Methods: </strong>The primary outcome was to assess the feasibility of modern laptop-style POCUS machines in a multiplace HBO₂ chamber. A secondary aim was to assess the reliability of POCUS images obtained at different pressures in a human subject in a multiplace chamber. Testing was initially conducted with one older machine (Sonosite 180 and Sonosite Micromaxx). Subsequently, two newer machines were studied (Sonosite Edge II and Mindray M9). Machine and transducer reliability were tested by performing a battery of POCUS imaging sequences: cardiac, FAST, inferior vena cava, and thoracic. The POCUS cardiac sequences evaluated included 2D, color Doppler, and M-mode.</p><p><strong>Results: </strong>Regarding feasibility, all machines functioned well at all depths/pressures. No instances of fire or spark were observed. No surface temperatures above 1200F were recorded. Regarding reliability, all machines performed adequately and completed the entire imaging sequence.</p><p><strong>Discussion: </strong>This study demonstrates the HBO₂ chamber safety of four laptop-style POCUS machines: Sonosite 180, Sonosite Micromaxx, Sonosite Edge II, and the Mindray M9. Our results also demonstrate excellent functionality of the newer Sonosite Edge II and Mindray machines. Secondarily, the reliability of POCUS images obtained at different pressures in a human subject has been verified.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"51-58"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678045","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":"Hyperbaric Oxygen Therapy in Stroke-Related Sudden Hearing Loss: A Case Report.","authors":"Sare Nur Kayacık, Fatma Zehra Gümüş Selek, Abdullah Aslan, Rabia Karabakan, Ümmühan Kıratlı","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Sudden sensorineural hearing loss (SSNHL) refers to a rapid decline in hearing of 30 dB or more that develops within three days, impacting at least three consecutive frequencies in one or both ears.</p><p><strong>Case report: </strong>This case report examines the improvement in hearing levels through hyperbaric oxygen treatment in a 74-year-old male patient who developed sudden hearing loss following a stroke.</p><p><strong>Discussion: </strong>After 15 days of neurological treatment, an audiological assessment revealed a 70 dB hearing loss in air conduction in the left ear. The patient initially received intravenous methylprednisolone for ten days, followed by five intratympanic steroid injections. Despite these treatments, no significant improvement in hearing was noted. The patient subsequently received 14 sessions of hyperbaric oxygen treatment, significantly improving hearing function.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"99-104"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678001","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":"Registered Nurses in Hyperbaric Medicine: Increasing Patient Compliance with Hyperbaric Oxygen Therapy.","authors":"Sydney Hurlburt, Drue Orwig","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>A quantitative analysis explored whether adding a full-time registered nurse (RN) and implementing nurse-led education and follow-up within the hyperbaric department affects patient treatment compliance and daily attendance rates.</p><p><strong>Methods: </strong>Data from two seven-month periods of hyperbaric appointments were retrospectively reviewed. Period One consists of canceled appointments from January to July 2023, when there was no dedicated nursing role in the department. Period 2 consists of canceled appointments from January to July 2024, following the addition of a full-time RN to the staffing matrix and the integration of nurse-led education into the department's workflow.</p><p><strong>Results: </strong>A chi-square test of the data showed a significant association (p < 0.001) between the addition of a full-time RN, nurse-led education, and follow-ups, and the number of canceled hyperbaric appointments. The estimated risk of cancellation prior to the interventions was 0.11, 11% higher than the rate after a dedicated nursing role was implemented (p-value < 0.001 and 95% CI for the proportion difference (0.087-0.13)). The odds of patients canceling hyperbaric appointments are 107% higher in departments without a dedicated RN role (p < 0.001). The OR=2.07, 95% CI (1.78 - 2.4).</p><p><strong>Discussion: </strong>After reviewing attendance data across two seven-month periods, it was concluded that there was an average decrease of 11% in missed appointments following the integration of a full-time RN, nurse-led education, and patient follow-up. Nursing involvement has been shown to improve compliance rates among hyperbaric patients.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"59-64"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678004","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":"Maximal fat oxidation in navy divers.","authors":"Clara Sjöblom, Lars Ekman, Oscar Plogmark, Mirko Mandić, Lara Rodríguez-Zamora, Anna K Melin, Magnus Ekström, Oskar Frånberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Oxidating fat as an energy substrate requires more oxygen than utilizing carbohydrates and can be acutely increased by hyperoxia. Therefore, substrate utilization may affect endurance performance and gas consumption in divers, but previous research is limited. This study aimed to evaluate changes in maximal fat oxidation (MFO) in navy divers during training.</p><p><strong>Methods: </strong>Seven explosive ordnance disposal (EOD) divers (age 20.0±1.4, BMI 23.5±1.6), five combat divers (age 23.6±3.0, BMI 26.2±1.2), and seven amphibious rangers (controls) (age 23.0±2.9, BMI 26.2±1.7) were recruited. MFO was measured with indirect calorimetry using an incremental test before and after diver training of 15 weeks (EOD divers) or 16 weeks spaced over nine months (combat divers and controls). EOD divers performed a treadmill protocol in normoxia and hyperoxia, and combat divers and controls performed a bicycle ergometer protocol in normoxia.</p><p><strong>Results: </strong>Combat divers increased their MFO with 0.14 g/minute ([95 % CI] 0.04 to 0.23) while no difference was observed in EOD divers (-0.05 g/minute; -0.19 to 0.08) or controls (0.00 g/minute; -0.14 to 0.14).</p><p><strong>Discussion: </strong>Combat diver training can increase fat oxidation, potentially affecting oxygen consumption and carbon dioxide production. A combination of training stressors, including hyperoxia, training load, and negative energy balance, may cause these changes.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"19-30"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678022","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":"Vascular occlusion following hyaluronic acid injection: A case report.","authors":"Recep Özkan, Buyçe Kaya, Güven Kaya","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This case presentation discusses vascular occlusion following hyaluronic acid (HA) injection and the subsequent treatment.</p><p><strong>Case report: </strong>A 52-year-old female underwent a 0.2 ml HA filler injection for aesthetic purposes in the forehead area, followed by the development of discoloration and severe pain extending from the glabellar region to the forehead.</p><p><strong>Discussion: </strong>The diagnosis was determined as vascular occlusion due to the injection, and the patient received 300 IU of hyaluronidase immediately. Additionally, hyperbaric oxygen treatment (HBO₂) was initiated. The patient received seven HBO₂ treatments and healed without developing post-treatment necrosis. No scar formation was observed at the three-month follow-up. This case highlights the potential benefits of HBO₂ in managing complications arising from HA fillers. It underscores the importance of physicians performing aesthetic procedures, being attentive to facial anatomy and injection techniques to prevent such complications. Furthermore, having knowledge about the effectiveness of HBO₂ in potential complication scenarios and collaboration with hyperbaric clinics when necessary are recommended.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"47-50"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678095","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":"Severe Anemia.","authors":"Keith W Van Meter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hyperbaric oxygen (HBO₂) therapy serves as a critical bridge treatment for severe anemia when red blood cell transfusion is not possible due to religious objection, crossmatch incompatibility, or blood unavailability. Hemoglobin levels below 3.6 g/dL are clearly inadequate for tissue oxygenation, and accumulative oxygen debt exceeding 33 L/m2 within four hours of severe hemorrhage is unsurvivable. HBO₂ administered at pressures of 2 to 3 ATA dissolves sufficient oxygen directly in plasma to compensate for the deficit in hemoglobin-bound oxygen-carrying capacity, while concurrent use of hematinics and erythropoietin-stimulating strategies supports endogenous red blood cell regeneration during surface intervals between treatments. Controlled animal studies spanning from 1943 through the 1990s consistently demonstrate improved survival in HBO₂-treated groups compared to normobaric air controls across multiple hemorrhagic shock models; human case reports, case series, and one controlled prospective trial in post-hepatectomy patients further support clinical efficacy. Classified as an AHA Class IIb indication with long-standing CMS approval, HBO₂ carries a cost comparable to a single unit of packed red blood cells and maintains a favorable safety profile with few and infrequent side effects. These findings position HBO₂ as a practical, low-technology, cost-competitive intervention for reducing accumulated oxygen debt in critically anemic patients across settings including emergency departments, operative units, and intensive care environments.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"199-208"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678113","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":"Risk Factors of Dysbaric Osteonecrosis in Saturation Diving Identified through Magnetic Resonance Imaging Surveillance.","authors":"Yuka Miyoshi, Shun Watanabe, Satoshi Tsukazaki, Takao Sugiura, Fumitaka Ikomi, Teppei Tanaka, Hitoshi Ogawa, Takehito Sawamura","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Only a few cohort studies have investigated dysbaric osteonecrosis (DON) in saturation diving (SD) divers using magnetic resonance imaging (MRI) to detect early-stage DON. We aimed to investigate DON in the Japan Maritime Self-Defense Force (JMSDF) deep SD divers using MRI and examined the relationship between DON and the risk factors.</p><p><strong>Methods: </strong>This study included 62 JMSDF SD divers. DON was diagnosed in the subjects' shoulders, hips, and knee joints using MRI and their clinical information. We analyzed subjects' diving records, including pre- and post-diving medical check information such as decompression sickness (DCS) and pain +/-. Data from the annual JMSDF health checks were analyzed to identify risk factors for DON based on divers' predispositions, lifestyles, and diving profiles.</p><p><strong>Results: </strong>Of the 62 saturation divers (mean age: 40.61±6.93 years), three (4.8%) showed evidence of DON. MRI showed a geographic lesion with symptoms or a history of DCS. Two divers with DON had knee pain and a history of DCS. Furthermore, one asymptomatic diver and another diver with pain were heavy drinkers. Regarding physical and biochemical examination, diastolic blood pressure and high-density lipoprotein-cholesterol were identified as significant risk factors in an unpaired t-test (DON+ vs. DON-).</p><p><strong>Discussion: </strong>Our findings suggest that SD is associated with a higher risk of DON, the early stage of which can be detected using MRI. The possible risk factors for DON were a previous history of DCS, diastolic BP, and HDL cholesterol, suggesting that ischemia could be involved in DON pathogenesis.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"35-46"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678153","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":"Hyperbaric Oxygen Therapy in Traumatic Brain Injury: A Comprehensive Structure Review.","authors":"Azizul Fadzli Jusoh, Ismawati Ismail, Rosliza Yahaya, Azlie Hassan, Harmy Mohamed Yusoff","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hyperbaric oxygen (HBO₂) treatment has sparked increasing attention as a potential therapeutic intervention for traumatic brain injury (TBI), but the variability in findings necessitates a comprehensive analysis of recent literature. This review aims to evaluate the latest empirical evidence on the effectiveness of HBO₂ treatment for TBI, focusing on its impact on neurological recovery, cognitive function, and physiological markers.</p><p><strong>Methods: </strong>To achieve this, we extensively searched scholarly articles in reputable databases such as Scopus and Web of Science (WoS), focusing on studies published between 2015 and 2024, and followed the PRISMA framework for study selection. The final dataset comprised 74 cases (n=74) and was analyzed using both quantitative methods (descriptive statistics) and qualitative techniques (thematic analysis). The findings were divided into three themes: (1) clinical efficacy of HBO₂ treatment for TBI, (2) mechanisms of action and biological pathways in HBO₂ treatment, and (3) evolving therapeutic applications of HBO₂ in TBI.</p><p><strong>Results: </strong>Mixed outcomes; while some studies reported significant cognitive, physiological, and clinical improvements, others raised concerns about methodological variability and limited reproducibility. Mechanistic studies highlighted HBO₂'s role in modulating pathways such as TLR4/NF-κB and VEGF/ERK, facilitating neuroprotection, angiogenesis, and synaptogenesis. Emerging therapies combining HBO₂ with regenerative approaches, such as stem cell treatments, showed promise in enhancing recovery.</p><p><strong>Discussion: </strong>In conclusion, HBO₂ treatment demonstrates clinical efficacy in improving memory, executive function, and neuroprotection, particularly in the treatment of post-concussive symptoms. Mechanistic studies highlight its role in reducing neuroinflammation and oxidative stress while promoting neurogenesis and angiogenesis. However, standardized protocols and long-term follow-up are needed to confirm its full therapeutic potential in TBI management.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"65-82"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677990","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":"Dysbaric osteonecrosis: Case series osteonecrosis in divers.","authors":"Ayatoulah Amamri, Abdelghani Miliani, Rym Boudour, Youçef Mellal, Mahmoud Dib, Mohamed Medaouar, Ali Bedjaoui","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>This is the first published study examining decompression illness (DCI) among divers in Algeria. DCI is a complex syndrome caused by bubbles of inert gas that form in the body due to an improper decompression process, following exposure to increased pressure underwater. Algerian diving conditions pose significant challenges to divers. The study focuses on red coral diving, a popular and long-standing practice in eastern Algeria. We present three case reports describing dysbaric osteonecrosis of the humeral head with varying degrees of severity and presentation. Dysbaric osteonecrosis (DON), a rare complication in professional divers and compressed-air workers, presents a controversial link to previous decompression sickness (DCS) with musculoskeletal pain (type 1 DCS). The potential for these ischemic lesions to progress to osteonecrosis after DCS remains unclear.</p><p><strong>Case report: </strong>This report describes a professional diver declared permanently unfit for diving due to advanced dysbaric osteonecrosis of the shoulder, following type 1 DCS in the same region treated with hyperbaric oxygen therapy. This case highlights the potential association between these events and emphasizes the importance of close monitoring after acute type 1 DCS.</p><p><strong>Discussion: </strong>Early magnetic resonance imaging (MRI) evaluation of all DCS cases with musculoskeletal pain is recommended to detect potential osteo-medullary damage. Such damage could worsen with continued diving and potentially transition into bone necrosis.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"83-89"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678013","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":"Case of Broca's Aphasia as an expression of cerebral decompression sickness with advanced non-invasive monitoring during HBO₂ treatment.","authors":"Gerald Schmitz, Sharon Aguero, Luis Carlos Huertas Gabert","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>We present a case of severe CNS decompression sickness (DCS) that included Broca's aphasia in a recreational diver, offering insights into the application of advanced non-invasive monitoring during hyperbaric oxygen treatment (HBO₂).</p><p><strong>Case report: </strong>This 64-year-old male diver experienced the onset of expressive aphasia, vertigo, and right-sided hemiparesis about 30-120 minutes after surfacing following a rapid ascent after a deep dive.</p><p><strong>Discussion: </strong>Initial monitoring with bispectral index (BIS) and density spectral array (DSA) revealed significant asymmetry between cerebral hemispheres, particularly in spectral edge frequency (SEF) values, with the left hemisphere showing a marked reduction during air breaks at HBO₂ pressures. This pattern resolved progressively over three HBO₂ sessions, with full clinical recovery after four sessions, coinciding with the resolution of this DSA hemispheric asymmetry. The case indirectly supports the theoretical roles of microparticles and endothelial dysfunction in contributing to cerebral hypoperfusion in DCS, beyond the conventional focus on gas bubbles, as reflected in the clinical findings and the clinical gradient. This novel application of BIS-DSA in hyperbaric medicine offers promising potential for real-time monitoring of cerebral involvement. It could enhance patient outcomes by guiding individualized treatment in neurologically compromised DCS cases.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"53 1","pages":"91-97"},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678038","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}