Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc最新文献

{"title":"Carbon monoxide-induced atrial fibrillation resolved with hyperbaric oxygen.","authors":"Corey Toocheck,&nbsp;David Bahner,&nbsp;Daniel J Bachmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Carbon monoxide (CO) exposure is a prevalent cause of poisoning worldwide. The cardiac effects of CO poisoning are well described and can manifest as angina, myocardial ischemia or infarction, cardiogenic shock, and/or life-threatening arrhythmias. Atrial fibrillation has been associated with severe CO poisoning; however, few cases have described atrial fibrillation in acute CO poisoning with regard to hyperbaric oxygen (HBO2) therapy. Herein, we describe a case of severe CO poisoning that caused atrial fibrillation with successful conversion to sinus rhythm following HBO2 therapy and discuss implications for further research.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"145-149"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperbaric oxygen therapy awareness within a doctor population.","authors":"Kurt Magri,&nbsp;Sarah Bigeni,&nbsp;Charles Paul Azzopardi,&nbsp;Liberato Camilleri,&nbsp;Lyubisa Matity,&nbsp;Stephen Muscat,&nbsp;Wilhelm Albertus Jacobus Meintjes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hyperbaric medicine is a relatively young specialty that remains in the blind spot of most doctors' awareness. This study endeavors to identify the level of awareness of the indications for hyperbaric oxygen (HBO2) therapy among a doctor population in a developed country and factors which may improve referral rates. An anonymized questionnaire was distributed to doctors licensed to practice in Malta. Questions included physician specialty, demographics and previous exposure to diving and/or hyperbaric medicine. Moreover, two scoring systems were used to score subjects on HBO2-related topics. Binomial logistic regression models and generalized linear models were used in the statistical analysis. A total of 152 full replies were obtained and analyzed. Respondents who had visited a hyperbaric unit (HBU) (p=0.002) or attended a lecture on HBO2 (p=0.006) scored better than their counterparts, indicating better awareness of HBO2 indications and local chamber location. A previous HBU visit (p=0.001), being a hospital-based doctor (p=0.027) and a history of scuba diving (p=0.03) were associated with willingness to refer patients for HBO2 in the future. Encouraging visits to an HBU has been shown to be associated with multiple factors, which are expected to result in improved referral rates. Targeted educational sessions to doctors and medical students are likely to be beneficial in improving correct referral of patients for HBO2. The findings from this study may prove useful in improving appropriate referral rates of patients who may benefit from this useful treatment modality.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"39-50"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37741391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic decompression illness cognitive dysfunction improved with hyperbaric oxygen: a case report.","authors":"Kimberly T Bradley,&nbsp;Jamie L Jamie L Krassow,&nbsp;Michael F Richards,&nbsp;Devin P Beckstrand,&nbsp;E George Wolf","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Altitude chamber exposures are used for training to allow aircrew to experience their hypoxia and pressure effect symptoms. Decompression illness (DCI) can occur subsequent to altitude chamber training or in operational aircraft when the cabin altitude is at least 18,000 feet. Definitive emergent treatment is hyperbaric oxygen (HBO2) to decrease bubble size, dissipate excess nitrogen, hyperoxygenate tissue and reduce inflammation.</p><p><strong>Case report: </strong>A 27-year-old female underwent altitude chamber training to 25,000 feet. She developed tingling in both legs and left arm, headache, dizziness, malaise, then difficulty talking. She underwent two HBO2 treatments. Over the next 12 months, she had paresthesia, decreased memory and cognitive function similar to symptoms seen following traumatic brain injury. She was referred 14 months after the event for evaluation. Using pre-deployment Automated Neuropsychological Assessment Metrics (ANAM) and serial tests over 58 HBO2 treatments, the patient demonstrated near-return to her pre-deployment test scores..</p><p><strong>Discussion: </strong>The reason for HBO2 treatment was based on previous experience with chronic traumatic brain injury subjects where HBO2 improved outcome. The patient's chronic neurological symptoms mimicked chronic TBI. The patient was unique in that baseline cognitive tests existed that could be used to monitor her changes during the treatment series.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"131-137"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of heliox non-saturation diving on the cardiovascular system and cognitive functions.","authors":"Dal-Woo Lee,&nbsp;Su-Jeen Jung,&nbsp;Jeong-Sun Ju","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The purpose of this study was to investigate the effects of a single bout of heliox non-saturation diving on the cardiovascular system and cognitive function. Ten recreational scuba divers (10 males, ∼35 years old) participated in this study. These subjects made two pool dives within a one-week interval, alternating gases with compressed air (21% O2, 79% N2) and with heliox (21% O2 and 79% He). The depth was to 26 meters over a 20-minute duration. The results showed that heliox diving significantly increased blood O2 saturation by 1.15% and significantly decreased blood lactate levels by ∼57% when compared with air diving (P ≺ 0.05). However, there were no significant differences in resting heart rate, systolic or diastolic pressure, core body blood pressure, and pulse wave velocity between the heliox and air dives. The Stroop test showed that the heliox dive significantly increased cognitive function compared with the air dive in both the simple test (Offtime) and interference test (Ontime) (P ≺ 0.05). It was concluded that the heliox dive increases blood O2 saturation and decreases blood lactate concentration when compared with air dives. These conditions are likely to help divers reduce hypoxia in the water, reduce the risk of loss of consciousness, reduce fatigue and allow them to dive for longer. Heliox diving may also help judgment and risk coping skills in the water due to the improvement of cognitive ability as compared to air breathing dives.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"93-100"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbon monoxide poisoning can act as a stress test to reveal underlying coronary artery disease: case report.","authors":"Jinfeng Jiang,&nbsp;Jeffrey S Cooper","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Carbon monoxide (CO) poisoning presents with many different cardiac effects, but one important presentation is its effect as a CO stress test to reveal underlying coronary artery disease (CAD). There are a limited number of publications detailing this phenomenon, but after CO intoxication it is important to suspect CAD in association with mild troponin leak or non-ST segment elevation myocardial infarction (NSTEMI) shown on electrocardiogram (EKG). We recently treated three patients with CO poisoning who had underlying CAD. In the first case a man presented to the emergency department with CO toxicity and an ST segment elevation myocardial infarction (STEMI), resulting in emergent angioplasty and the discovery of severe CAD. The second case involved an individual who presented with CO poisoning with rising troponin levels. An angioplasty discovered a stable 90% occlusion. The third case was a patient with CO poisoning and transient inferior T wave inversion EKG with borderline troponin elevation. Angioplasty showed only 30% occlusion, so the patient's presentation was likely due to direct CO cardiac toxicity. These cases demonstrate the varied presentations that CO poisoning can have on patients with underlying heart disease.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"139-143"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum for PMID: 31689017.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In the fourth quarter issue 2020 of the UHM Journal (46-5)\u0000we represented the NNT number (number-needed-to-treat)\u0000as “three (3)” rather than simply “3.”\u0000This appeared on Page 727 in the letter from Richard\u0000Clarke, CHT, National Baromedical Services, entitled\u0000“HBO2 for radiation cystitis.” The corrected section should\u0000have read:\u0000“Although not reported, the ‘Number Needed to Treat’\u0000(NNT, an epidemiological measure used to communicate\u0000effectiveness of an intervention, and representing the\u0000average number of patients needed to be treated in order\u0000to produce one favorable outcome) was computed as an\u0000encouraging 3. This value was the same for the subjective\u0000Expanded Prostate Index Composite (EPIC) and objective\u0000Late Radiation Morbidity Grading Scheme (LRMGS)\u0000scores, rounded up by convention from 2.56 and 2.17,\u0000respectively.”</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"176"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37741174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperbaric oxygen treatment results in a group of Turkish central retinal artery occlusion patients with a combined presence of thrombophilic mutations.","authors":"Muhammer Özgür Çevik,&nbsp;Bekir Selim Bagli,&nbsp;Sadik Görkem Çevik","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Central retinal artery occlusion (CRAO) is a rare ocular-ischemic syndrome causing irreversible blindness. Its pathophysiology has not been clarified, and no targeted therapies are available yet. Hyperbaric oxygen (HBO2) therapy is already an approved therapy for CRAO and has been shown to improve the visual acuity of CRAO patients safely. However, further clinical data are required to classify HBO2 therapy as a type-I general agreement for CRAO.</p><p><strong>Materials and methods: </strong>Eleven patients with non-arteritic CRAO were enrolled. Patient demographics, medical history, detailed eye examinations, HBO2 therapy results, pre-/post HBO2 therapy visual acuity measurements and genotypes for common thrombophilic mutations (Factor V G1691A Leiden, Factor II G20210A, MTHFR A1298C, MTHFR C677T, and PAI-1-675 4G/5G) were obtained.</p><p><strong>Result: </strong>Six patients (54%) responded to HBO2 therapy compared to five non-responders (46%). Patients admitted before 12 hours responded well to HBO2 therapy. No systemic diseases nor advanced age were statistically correlated to CRAO. A combination of mutations rather than single mutations for each patient could be seen as responsible for CRAO. No Factor V G1691A Leiden mutations and only one FII G20210A mutation were observed. Eight patients (72%) had MTHFR 677T allele, five patients (45%) had MTHFR 1298C allele, and 10 patients (91%) had the PAI-1-675 4G allele.</p><p><strong>Conclusion: </strong>Not a single mutation but a combination of mutations and other unknown factors probably lead to CRAO, and if intervention is timely, HBO2 therapy offers improvement in visual acuity safely.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"65-73"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rescue and resuscitation factors in scuba diving and snorkeling fatalities in Australia, 2001-2013.","authors":"John Lippmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to examine first aid measures applied in a large series of Australian dive-related fatalities to better determine where improvements can be made.</p><p><strong>Methods: </strong>The National Coronial Information System was searched to identify scuba diving and snorkeling-related cases reported to various Australian Coroners for the years 2001-2013 inclusive. Coronial documents examined included witness statements, police reports and ambulance and medical reports where available. Information relating to the recovery, rescue and/or resuscitation of the victims was extracted, compiled and analyzed.</p><p><strong>Results: </strong>126 scuba diving and 175 snorkeling-related fatalities were identified during the study period, with airway management complications reported in one-third. Cardiopulmonary resuscitation was performed in three-quarters of the incidents. An automated external defibrillator was attached to 40 victims as a first aid measure, and shocks were indicated and delivered in five cases. Although three-quarters of the reports included no information about whether supplemental oxygen was provided, it was confirmed in 19% of both the scuba diving and snorkeling incidents.</p><p><strong>Conclusion: </strong>There were often considerable delays in the recognition, rescue and/or recovery of an unconscious snorkeler or diver and, consequently, the time to commencement of basic life support. Such delays can affect chances of survival and need to be minimized. Delivery of supplemental oxygen during resuscitation appears to be relatively infrequent and sometimes suboptimal; improvement appears necessary. Some measures that would have improved availability and/or better use in these cases include the selection of appropriate equipment compatible with likely circumstances and operator skills; improved training and ongoing skills practice; and regular checking and maintenance of equipment. Improved data collection and recording by official on-site investigators, preferably with knowledge of diving, would better inform potential or necessary improvements.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"101-109"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carbon monoxide poisoning.","authors":"Lindell K Weaver","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Despite established exposure limits and safety standards as well as the availability of carbon monoxide (CO) alarms, each year 50,000 people in the United States visit emergency departments for CO poisoning. Carbon monoxide poisoning can occur from brief exposures to high levels of CO or from longer exposures to lower levels. Common symptoms can include headaches, nausea and vomiting, dizziness, general malaise, and altered mental status. Some patients may have chest pain, shortness of breath, and myocardial ischemia, and may require mechanical ventilation and treatment of shock. Individuals poisoned by CO often develop brain injury manifested by neurological problems, including cognitive sequelae, anxiety and depression, persistent headaches, dizziness, sleep problems, motor weakness, vestibular and balance problems, gaze abnormalities, peripheral neuropathies, hearing loss, tinnitus, Parkinsonian-like syndrome, and other problems. In addition, some will have cardiac issues or other ailments. While breathing oxygen hastens the removal of carboxyhemoglobin (COHb), hyperbaric oxygen (HBO2) hastens COHb elimination and favorably modulates inflammatory processes instigated by CO poisoning, an effect not observed with breathing normobaric oxygen. Hyperbaric oxygen improves mitochondrial function, inhibits lipid peroxidation transiently, impairs leukocyte adhesion to injured microvasculature, and reduces brain inflammation caused by the CO-induced adduct formation of myelin basic protein. Based upon three supportive randomized clinical trials in humans and considerable evidence from animal studies, HBO2 should be considered for all cases of acute symptomatic CO poisoning. Hyperbaric oxygen is indicated for CO poisoning complicated by cyanide poisoning, often concomitantly with smoke inhalation.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"151-169"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of adjunctive hyperbaric oxygen therapy in patients with central retinal artery occlusion.","authors":"Yoon-Seop Kim,&nbsp;Myung-Sik Nam,&nbsp;Eung Joo Park,&nbsp;Yoonsuk Lee,&nbsp;Hyun Kim,&nbsp;Soo Han Kim,&nbsp;Yong Sung Cha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>Central retinal artery occlusion (CRAO) is an ophthalmic emergency with poor prognosis, despite diligent conventional treatment. According to the clinical recommendations of the Undersea and Hyperbaric Medical Society, hyperbaric oxygen (HBO2) is a potentially beneficial treatment; however, the benefit of adjunctive HBO2 in patients with CRAO in Korea remains unclear. The present study aimed to evaluate the effect of adjunctive HBO2 in patients with CRAO.</p><p><strong>Methods: </strong>This registry-based observational study included adult patients who presented to the emergency department or ophthalmology outpatient department within 24 hours of the onset of CRAO symptoms. Data of patients from October 2016 to February 2019 were analyzed. The patients were categorized into two groups according to the use of adjunctive HBO2: no HBO2 and HBO2.</p><p><strong>Result: </strong>During the study period, 34 consecutive patients were enrolled, of which 19 were included in the study. In the total cohort, 10 patients (52.6%) were treated with adjunctive HBO2. There were no statistically significant differences in terms of age, sex, comorbidities, duration from symptoms onset to hospital visit, presence of the cilioretinal artery, and use of anterior chamber paracentesis between the two groups. The HBO2 group showed significantly higher change in best-corrected visual acuity than the no HBO2 group (p=0.043).</p><p><strong>Conclusion: </strong>Patients with CRAO in the HBO2 group showed significantly greater visual improvement than those in the no-HBO2 group. Clinicians should consider adjunctive HBO2 in the treatment approach in patients with CRAO who visit the hospital within 24 hours of symptoms onset.</p>","PeriodicalId":520823,"journal":{"name":"Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc","volume":" ","pages":"57-64"},"PeriodicalIF":0.9,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37742272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}