Undersea and Hyperbaric Medicine最新文献

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Inner ear decompression sickness after a routine dive and recompression chamber drill. 例行潜水和减压舱演习后出现内耳减压病。
IF 0.7 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-02-01
Dale Parsons, Edward Utz, Grant Kidd, Gina Virgilio
{"title":"Inner ear decompression sickness after a routine dive and recompression chamber drill.","authors":"Dale Parsons, Edward Utz, Grant Kidd, Gina Virgilio","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Inner ear decompression sickness (IEDCS) is an uncommon diving-related injury affecting the vestibulocochlear system, with symptoms typically including vertigo, tinnitus, and hearing loss, either in isolation or combination. Classically associated with deep, mixed-gas diving, more recent case series have shown that IEDCS is indeed possible after seemingly innocuous recreational dives, and there has been one previous report of IEDCS following routine hyperbaric chamber operations. The presence of right-to-left shunt (RLS), dehydration, and increases in intrathoracic pressure have been identified as risk factors for IEDCS, and previous studies have shown a predominance of vestibular rather than cochlear symptoms, with a preference for lateralization to the right side. Most importantly, rapid identification and initiation of recompression treatment are critical to preventing long-term or permanent inner ear deficits. This case of a U.S. Navy (USN) diver with previously unidentified RLS reemphasizes the potential for IEDCS following uncomplicated diving and recompression chamber operations - only the second reported instance of the latter.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 2","pages":"129-135"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564940","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}
引用次数: 0
Nathanial Henshaw: Not history's pioneering hyperbaric practitioner. 纳撒尼尔-亨肖并非历史上的高压氧治疗先驱。
IF 0.7 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-02-01
Richard Clarke
{"title":"Nathanial Henshaw: Not history's pioneering hyperbaric practitioner.","authors":"Richard Clarke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A widely accepted belief is that Nathaniel Henshaw was the first practitioner of hyperbaric medicine. He is said to have constructed the first hyperbaric chamber where he treated several disorders and provided opportunities to prevent disease and optimize well-being. While there is little doubt Henshaw was the first to conceptualize this unique medical technology, careful analysis of his treatise has convinced this writer that his was nothing more than a proposal. Henshaw's air chamber was never built. He would have failed to appreciate how its structural integrity could be maintained in the presence of enormous forces generated by envisioned changes in its internal pressure and, likewise, how its door could effectively seal the chamber during hypo-and hyperbaric use. Henshaw would have also failed to appreciate the limitations of his two proposed measuring devices and the toxic nature of one. Neither of these would have provided any quantitative information. The impracticality of his proposed method of compressing and decompressing the chamber is readily apparent. So, too, the likely toxic accumulation of carbon dioxide within the unventilated chamber during lengthy laborious periods required to operate it. Henshaw recommended pressures up to three times atmospheric pressure and durations for acute conditions until their resolution. Such exposures would likely result in fatal decompression sickness upon eventual chamber ascent, a condition of which nothing was known at the time. It would be another 170 years before a functional air chamber would finally become a reality. Henshaw's legacy, then, is limited to the concept of hyperbaric medicine rather than being its first practitioner.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 2","pages":"107-113"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564941","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}
引用次数: 0
Trends in Medicare Costs of Hyperbaric Oxygen Therapy, 2013 through 2022. 2013 年至 2022 年高压氧治疗的医疗保险费用趋势。
IF 0.7 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-02-01
Helen B Gelly, Caroline E Fife, David Walker, Kristen Allison Eckert
{"title":"Trends in Medicare Costs of Hyperbaric Oxygen Therapy, 2013 through 2022.","authors":"Helen B Gelly, Caroline E Fife, David Walker, Kristen Allison Eckert","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze Hyperbaric Oxygen Therapy Registry (HBOTR) data to estimate the Medicare costs of hyperbaric oxygen therapy (HBO<sub>2</sub>) based on standard treatment protocols and the annual mean number of treatments per patient reported by the registry.</p><p><strong>Methods: </strong>We performed a secondary analysis of deidentified data for all payers from 53 centers registered in the HBOTR from 2013 to 2022. We estimated the mean annual per-patient costs of HBO<sub>2</sub> based on Medicare (outpatient facility + physician) reimbursement fees adjusted to 2022 inflation using the Medicare Economic Index. Costs were calculated for the annual average number of treatments patients received each year and for a standard 40-treatment series. We estimated the 2022 costs of standard treatment protocols for HBO<sub>2</sub> indications treated in the outpatient setting.</p><p><strong>Results: </strong>Generally, all costs decreased from 2013 to 2022. The facility cost per patient per 40 HBO<sub>2</sub> treatments decreased by 10.7% from $21,568.58 in 2013 to $19,488.00 in 2022. The physician cost per patient per 40 treatments substantially decreased by -37.8%, from $5,993.16 to $4,346.40. The total cost per patient per 40 treatments decreased by 15.6% from $27,561.74 to $23,834.40. In 2022, a single HBO<sub>2</sub> session cost $595.86. For different indications, estimated costs ranged from $2,383.4-$8,342.04 for crush injuries to $17,875.80-$35,751.60 for diabetic foot ulcers and delayed radiation injuries.</p><p><strong>Conclusions: </strong>This real-world analysis of registry data demonstrates that the actual cost of HBO<sub>2</sub> is not nearly as costly as the literature has insinuated, and the per-patient cost to Medicare is decreasing, largely due to decreased physician costs.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 2","pages":"137-144"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564943","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}
引用次数: 0
Hyperbaric oxygen (HBO2) therapy in thermal burn injury revisited. Pressure does matter. Review. 热烧伤中的高压氧疗法(HBO2)再探。压力确实很重要。回顾。
IF 0.7 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-02-01
Christian Smolle, Daniel Auinger, Jörg Lindenmann, Josef Smolle, Freyja-Maria Smolle-Juettner, Lars-Peter Kamolz
{"title":"Hyperbaric oxygen (HBO<sub>2</sub>) therapy in thermal burn injury revisited. Pressure does matter. Review.","authors":"Christian Smolle, Daniel Auinger, Jörg Lindenmann, Josef Smolle, Freyja-Maria Smolle-Juettner, Lars-Peter Kamolz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>For over five decades, many experimental and clinical studies have shown predominantly positive but controversial results on the efficacy of hyperbaric oxygen (HBO<sub>2</sub>) therapy in burns. The study aimed to define a common denominator or constellations, respectively, linked to the effects of HBO<sub>2</sub> in burns with a special focus on dosage parameters. Based on original work since 1965, species, number of individuals, type of study, percentage of total body surface area (TBSA), region, depth of burn, causative agent, interval between burn and first HBO2 session, pressure, duration of individual session, number of HBO<sub>2</sub> sessions per day, cumulative number of HBO<sub>2</sub> sessions and type of chamber were assessed. Out of 47 publications included, 32 were animal trials, four were trials in human volunteers, and 11 were clinical studies. They contained 94 experiments whose features were processed for statistical evaluation. 64 (67.4%) showed a positive outcome, 16 (17.9%) an ambiguous one, and 14 (14.7%) a negative outcome. The only factor independently influencing the results was pressure with ATA (atmospheres absolute) lower than 3 ATA being significantly associated with better outcomes (p=0.0005). There is a dire need for well-designed clinical studies in burn centers equipped with hyperbaric facilities to establish dedicated treatment protocols.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 2","pages":"115-127"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564939","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}
引用次数: 0
Cardiovascular effects of breath-hold diving at altitude. 高海拔憋气潜水对心血管的影响。
IF 0.7 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-02-01
Claudio Marabotti, Marco Laurino, Mirko Passera, Danilo Cialoni, Enrico Franzino, Chiara Benvenuti, Alessandro Pingitore
{"title":"Cardiovascular effects of breath-hold diving at altitude.","authors":"Claudio Marabotti, Marco Laurino, Mirko Passera, Danilo Cialoni, Enrico Franzino, Chiara Benvenuti, Alessandro Pingitore","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hypoxia, centralization of blood in pulmonary vessels, and increased cardiac output during physical exertion are the pathogenetic pathways of acute pulmonary edema observed during exposure to extraordinary environments. This study aimed to evaluate the effects of breath-hold diving at altitude, which exposes simultaneously to several of the stimuli mentioned above. To this aim, 11 healthy male experienced divers (age 18-52y) were evaluated (by Doppler echocardiography, lung echography to evaluate ultrasound lung B-lines (BL), hemoglobin saturation, arterial blood pressure, fractional NO (Nitrous Oxide) exhalation in basal condition (altitude 300m asl), at altitude (2507m asl) and after breath-hold diving at altitude. A significant increase in E/e' ratio (a Doppler-echocardiographic index of left atrial pressure) was observed at altitude, with no further change after the diving session. The number of BL significantly increased after diving at altitude as compared to basal conditions. Finally, fractional exhaled nitrous oxide was significantly reduced by altitude; no further change was observed after diving. Our results suggest that exposure to hypoxia may increase left ventricular filling pressure and, in turn, pulmonary capillary pressure. Breath-hold diving at altitude may contribute to interstitial edema (as evaluated by BL score), possibly because of physical efforts made during a diving session. The reduction of exhaled nitrous oxide at altitude confirms previous reports of nitrous oxide reduction after repeated exposure to hypoxic stimuli. This finding should be further investigated since reduced nitrous oxide production in hypoxic conditions has been reported in subjects prone to high-altitude pulmonary edema.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 2","pages":"189-196"},"PeriodicalIF":0.7,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564936","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}
引用次数: 0
Relation between resting spleen volume and apnea-induced increases in hemoglobin mass. 静息脾脏体积与呼吸暂停引起的血红蛋白质量增加之间的关系。
IF 0.9 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-01-01
Jason M Keeler, Hayden W Hess, Erica Tourula, Robert F Chapman, Blair D Johnson, Zachary J Schlader
{"title":"Relation between resting spleen volume and apnea-induced increases in hemoglobin mass.","authors":"Jason M Keeler, Hayden W Hess, Erica Tourula, Robert F Chapman, Blair D Johnson, Zachary J Schlader","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Indigenous populations renowned for apneic diving have comparatively large spleen volumes. It has been proposed that a larger spleen translates to heightened apnea-induced splenic contraction and elevations in circulating hemoglobin mass (Hb<sub>mass</sub>), which, in theory, improves O<sub>2</sub> carrying and/or CO<sub>2</sub>/pH buffering capacities. However, the relation between resting spleen volume and apnea- induced increases in Hb<sub>mass</sub> is unknown. Therefore, we tested the hypothesis that resting spleen volume is positively related to apnea-induced increases in total Hb<sub>mass</sub>.</p><p><strong>Methods: </strong>Fourteen healthy adults (six women; 29 ± 5 years) completed a two-minute carbon monoxide rebreathe procedure to measure pre-apneas Hb<sub>mass</sub> and blood volume. Spleen length, width, and thickness were measured pre-and post-five maximal apneas via ultrasound. Spleen volume was calculated via the Pilström equation (test-retest CV:2 ± 2%). Hemoglobin concentration ([Hb]; g/dl) and hematocrit (%) were measured pre- and post-apneas via capillary blood samples. Post-apneas Hb<sub>mass</sub> was estimated as post-apnea [Hb] x pre-apnea blood volume. Data are presented as mean ± SD.</p><p><strong>Results: </strong>Spleen volume decreased from pre- (247 ± 95 mL) to post- (200 ± 82 mL, p<0.01) apneas. [Hb] (14.6 ± 1.2 vs. 14.9 ± 1.2 g/dL, p<0.01), hematocrit (44 ± 3 vs. 45 ± 3%, p=0.04), and Hb<sub>mass</sub> (1025 ± 322 vs. 1046 ± 339 g, p=0.03) increased from pre- to post-apneas. Pre-apneas spleen volume was unrelated to post-apneas increases in Hb<sub>mass</sub> (r=-0.02, p=0.47). O<sub>2</sub> (+28 ± 31 mL, p<0.01) and CO<sub>2</sub> (+31 ± 35 mL, p<0.01) carrying capacities increased post-apneas.</p><p><strong>Conclusion: </strong>Larger spleen volume is not associated with a greater rise in apneas-induced increases in Hb<sub>mass</sub> in non-apnea-trained healthy adults.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 1","pages":"59-69"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874932","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}
引用次数: 0
Chondronecrosis of the cricoid treated with hyperbaric oxygen therapy: A case series. 用高压氧疗法治疗环状软骨坏死:病例系列。
IF 0.9 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-01-01
John David Spencer, Tyler Connely, Jeffrey Cooper, Jayme Rose Dowdall
{"title":"Chondronecrosis of the cricoid treated with hyperbaric oxygen therapy: A case series.","authors":"John David Spencer, Tyler Connely, Jeffrey Cooper, Jayme Rose Dowdall","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We present two cases of cricoid chondronecrosis treated with hyperbaric oxygen (HBO<sub>2</sub>) therapy. Both patients presented with biphasic stridor and dyspnea several weeks after an intubation event. Tracheostomy was ultimately performed for airway protection, followed by antibiotic treatment and outpatient HBO<sub>2</sub> therapy. Both patients were decannulated within six months of presentation and after at least 20 HBO<sub>2</sub> therapy sessions. Despite a small sample size, our findings are consistent with data supporting HBO<sub>2</sub> therapy's effects on tissue edema, neovascularization, and HBO<sub>2</sub> potentiation of antibiotic treatment and leukocyte function. We suggest HBO<sub>2</sub> therapy may have accelerated airway decannulation by way of infection resolution as well as the revitalization of upper airway tissues, ultimately renewing the structural integrity of the larynx. When presented with this rare but significant clinical challenge, physicians should be aware of the potential benefits of HBO<sub>2</sub> therapy.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 1","pages":"53-58"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853332","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}
引用次数: 0
Physical and Physiological Predictors Determining the Maximal Static Apnea Diving Time of Male Freedivers. 决定男子自由潜水员最大静态呼吸暂停潜水时间的物理和生理预测因素。
IF 0.9 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-01-01
Dai-Woo Lee, Hongwei Yang, Jeong-Sun Ju
{"title":"Physical and Physiological Predictors Determining the Maximal Static Apnea Diving Time of Male Freedivers.","authors":"Dai-Woo Lee, Hongwei Yang, Jeong-Sun Ju","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study aimed to investigate what factors determine freedivers' maximal static apnea dive time. We correlated some physical/physiological factors with male freedivers' maximum apnea diving duration. Thirty-six experienced male freedivers participated in this study. The divers participated in two days of the experiments. On the first day, apnea diving time, blood oxygen saturation (SpO<sub>2</sub>), heart rate (HR), blood pressure (BP), stress index, and blood parameters were measured before, during, and after the apnea diving in the pool. On the second day, body composition, lung capacity, resting and maximal oxygen consumption (VO<sub>2</sub>max), and the Wingate anaerobic power were measured in the laboratory. The data were analyzed with Pearson's Correlation using the SPSS 22 program. The correlation coefficient (R) of determination was set at 0.4, and the level of significance was set at p <0.05. There were positive correlations of diving experience, maximum SpO<sub>2</sub>, and lung capacity with the maximum apnea time R>0.4, P<0.05). There were negative correlations of BMI, body fat percentage, body fat mass, minimum SpO<sub>2</sub>, stress index, and total cholesterol with the maximum apnea diving time (R>-0.4, P<0.05). No correlations of age, height, weight, fat-free mass, skeletal muscle mass, HR, BP, blood glucose, beta- hydroxybutyrate, lactate, and hemoglobin levels with the maximum apnea diving time were observed (R<0.4, P>0.05). It is concluded that more experience in freediving, reduced body fat, extended SpO<sub>2</sub> range, and increased lung capacity are the performance predictors and beneficial for freedivers to improve their maximum apnea diving performance.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 1","pages":"85-92"},"PeriodicalIF":0.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873304","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}
引用次数: 0
Barodontalgia during hyperbaric oxygen therapy of an 8-year-old male: A case report. 一名 8 岁男童在接受高压氧治疗期间出现牙周疼痛:病例报告
IF 0.7 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-01-01
Melisa Öçbe, Selin Gamze Sümen, Büşra Dilara Altun, Asim Dumlu
{"title":"Barodontalgia during hyperbaric oxygen therapy of an 8-year-old male: A case report.","authors":"Melisa Öçbe, Selin Gamze Sümen, Büşra Dilara Altun, Asim Dumlu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Barodontalgia, barometric pressure-induced dental pain, may occur during hyperbaric oxygen(HBO<sub>2</sub>) therapy due to pressure changes. This case report presents an 8-year-old male patient with barodontalgia. The patient declared a severe toothache during HBO<sub>2</sub> therapy. The diving medicine specialist referred the patient to the dental clinician immediately. On clinical examination, the pain was thought to be caused by caries lesions of the deciduous teeth in the left maxillary molar region. Tooth extraction was suggested. After extraction, the patient continued hyperbaric oxygen therapy sessions without any pain. The patient was recommended for an intraoral and radiographic examination session one week after the extraction. In conclusion, caries lesions and faulty restorations should be examined before hyperbaric oxygen therapy sessions. Even though barodontalgia is a rare phenomenon, dental examination is essential to avoid these kinds of pain-related complications. All carious lesions and defective restorations must be treated, if necessary. Removal of faulty restorations and management of inflammation as part of the treatment is suggested before exposure to pressure changes.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 1","pages":"47-51"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853308","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}
引用次数: 0
Medical and surgical management of pneumothorax in diving and hyperbaric chambers. 潜水和高压氧舱气胸的内科和外科治疗。
IF 0.7 4区 医学
Undersea and Hyperbaric Medicine Pub Date : 2024-01-01
Richard E Clarke, Keith Van Meter
{"title":"Medical and surgical management of pneumothorax in diving and hyperbaric chambers.","authors":"Richard E Clarke, Keith Van Meter","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The presence of a pneumothorax within a pressurized chamber represents unique diagnostic and management challenges. This is particularly the case in the medical and geographic remoteness of many chamber locations. Upon commencing chamber decompression, unvented intrapleural air expands. If its initial volume and/or degree of chamber pressure reduction is significant enough, a tension pneumothorax will result. Numerous reports chronicle failure to diagnose and manage in-chamber pneumothorax with resultant morbidity and one fatal outcome. Such cases have occurred in both medically remote and clinically based settings. This paper reviews pneumothorax and tension pneumothorax risk factors and clinical characteristics. It suggests primary medical management using the principle of oxygen-induced inherent unsaturation in concert with titrated chamber decompression designed to prevent intrapleural air expanding faster than it contracts. Should this conservative approach prove unsuccessful, and surgical venting becomes necessary or otherwise immediately indicated, interventional options are reviewed.</p>","PeriodicalId":49396,"journal":{"name":"Undersea and Hyperbaric Medicine","volume":"51 1","pages":"17-28"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853333","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}
引用次数: 0
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