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Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society

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https://www.readbyqxmd.com/read/29888387/evidence-brief-hyperbaric-oxygen-therapy-hbot-for-traumatic-brain-injury-and-or-post-traumatic-stress-disorder
#1
EDITORIAL
Michael H Bennett
This report is a product of the VA Evidence-based Synthesis Program. The purpose is to provide "timely and accurate syntheses of targeted healthcare topics …. to improve the health and healthcare of Veterans". The authors have made a comprehensive search and analysis of the literature and make recommendations to assist clinicians in dealing with veterans suffering from either traumatic brain injury (TBI) or post-traumatic stress disorder (PTSD). The report is timely and of great potential impact given the vigorous and lengthy debate among hyperbaric physicians and lay people determined to find an answer for the large numbers of veterans deeply affected with some combination of PTSD and post-concussion dysfunction...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888386/do-skin-rash-and-cutis-marmorata-stem-from-lamellar-bodies-within-the-skin
#2
LETTER
Ran Arieli
Cutis marmorata (CM) manifests as bluish-red spots on the skin following decompression. These are often itchy or painful to touch, and appear half to one hour after surfacing. The pathogenesis of skin lesions in decompression illness (DCI) remains unresolved. The common belief has been that bubbles that shunted to the arterial circulation reached the skin and clogged blood vessels. An alternative explanation from studies in which air was injected into the internal carotid artery of swine is that arterial bubbles at the brain stem disturb the control of skin blood flow, causing CM...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888385/acute-ophthalmic-artery-occlusion-in-decompression-illness-with-underlying-anterior-cerebral-artery-a1-segment-hypoplasia
#3
Ahmad Razif Omar, Mohtar Ibrahim, Adil Hussein
A diver presented with total loss of vision in the left eye and right hemiparesis following a routine no-stop scuba dive to 20 metres' depth. A diagnosis of decompression illness (DCI) with acute ophthalmic artery air embolism and left carotid artery insult causing acute anterior circulatory ischaemia was made. He underwent seven hyperbaric treatments leading to a full recovery. Magnetic resonance angiography revealed an underlying left anterior cerebral artery A1 segment hypoplasia. Making a prompt diagnosis and early hyperbaric oxygen treatment are crucial to halt further tissue damage from ischaemia in central nervous system DCI...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888384/problems-with-an-intrathecal-pump-in-a-paraplegic-scuba-diver
#4
Brahim Hacene, Nathalie Draulans, Tom Theys
Scuba diving with an intrathecal baclofen pump is encouraged for people with spinal cord injury who are suffering from spasticity. However, the diving depth is limited to 10 metres in this context. Proper physician and patient education in this respect is mandatory since non-compliance can lead to an irreversible loss of drug reservoir capacity due to collapse of the bottom shield. We report such an incident in a paraplegic diver diving to depths down to 30 metres' water.
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888383/repeated-hyperbaric-exposure-and-glass-ampoule-safety
#5
Soon Yee Teoh, Venkat Narasimham Vangaveti
INTRODUCTION: It has been our institution's policy to not place glass medication ampoules inside our hyperbaric chamber for fear of rupture. There is only a small and conflicting amount of data as to whether glass ampoules are safe for use under hyperbaric conditions. OBJECTIVES: The primary objective of this study was to test the safety and usability of glass medication ampoules inside a hyperbaric chamber. METHODS: Repetitive, rapidly staged compressions and decompressions were performed on multiple different glass medications ampoules inside the medical lock of a medical hyperbaric chamber...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888382/performance-of-the-oxylog%C3%A2-1000-portable-ventilator-in-a-hyperbaric-environment
#6
Lie Sui An, Loy Shun Ting, Lee Cheng Chuan, Kim Soo Joang, Soh Chai Rick
INTRODUCTION: The management of mechanically ventilated patients in the hyperbaric environment requires knowledge of how the physical properties of gases change under pressure and how this affects the operation of the ventilator. The primary objective of this study was to test the performance of the Dräger Oxylog 1000® ventilator in a hyperbaric environment. METHODS: Each of two ventilators was connected to a mechanical test lung system with an in-built pressure gauge...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888381/storage-of-partly-used-closed-circuit-rebreather-carbon-dioxide-absorbent-canisters
#7
Neal W Pollock, Nicholas Gant, David Harvey, Peter Mesley, Jason Hart, Simon J Mitchell
INTRODUCTION: Diving rebreathers use "scrubber" canisters containing soda lime to remove carbon dioxide (CO2 ) from the expired gas. Soda lime has a finite ability to absorb CO2 . We undertook an experiment to determine whether the manner of storage of a partly used scrubber affected subsequent CO2 absorption. METHODS: An Evolution Plus™ rebreather was mechanically ventilated in a benchtop circuit. Respiratory minute volume was 45 L·min-1 and CO2 was introduced to the expiratory limb at 2 L·min-1 ...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888380/in-water-recompression
#8
REVIEW
David J Doolette, Simon J Mitchell
Divers suspected of suffering decompression illness (DCI) in locations remote from a recompression chamber are sometimes treated with in-water recompression (IWR). There are no data that establish the benefits of IWR compared to conventional first aid with surface oxygen and transport to the nearest chamber. However, the theoretical benefit of IWR is that it can be initiated with a very short delay to recompression after onset of manifestations of DCI. Retrospective analyses of the effect on outcome of increasing delay generally do not capture this very short delay achievable with IWR...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888379/rhinologic-and-oral-maxillofacial-complications-from-scuba-diving-a-systematic-review-with-recommendations
#9
REVIEW
Devon M Livingstone, Beth Lange
Rhinologic and oral maxillofacial complications from scuba diving are common, representing approximately 35% of head and neck pathology related to diving. We performed a systematic and comprehensive literature review on the pathophysiology, diagnosis, and treatment of rhinologic and oral maxillofacial pathology related to diving. This included complications due to sinus barotrauma, barodontalgia, odontocrexis, temporomandibular joint dysfunction, partially dentulous patients, and considerations for patients following major head and neck surgery...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888378/audit-of-practice-in-australasian-hyperbaric-units-on-the-incidence-of-central-nervous-system-oxygen-toxicity
#10
Susannah Sherlock, Mandy Way, Alexis Tabah
INTRODUCTION: Central nervous system oxygen toxicity (CNS-OT) is an uncommon complication of hyperbaric oxygen treatment (HBOT). Different facilities have developed local protocols in an attempt to reduce the risk of CNS-OT. This audit was performed to elucidate which protocols might be of benefit in mitigating CNS-OT and to open discussion on adopting a common protocol for Treatment Table 14 (TT14) to enable future multicentre clinical trials. METHODS: Audit of CNS-OT events between units using different compression profiles for TT14, performed at 243 kPa with variable durations of oxygen breathing and 'air breaks', to assess whether there is a statistical diference between protocols...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29888377/the-future-of-diving-research-in-norway
#11
EDITORIAL
Andreas Møllerløkken
Norway has a long tradition of quality research within the field of baromedicine. With the discovery of oil in the North Sea, it became important to establish scientific research facilities to overcome immediate challenges, but also to work towards long-term goals. For the diving community, an understanding of the pathophysiology of decompression sickness (DCS) has been one of the major forces to maintain focus on the importance of scientific research in this field. In addition to oil, the aquaculture and fish farming industries are increasing in size and are Norway's second biggest export industry today...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557102/pre-hospital-management-of-decompression-illness-expert-review-of-key-principles-and-controversies
#12
Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K Butler, David J Doolette, James R Holm, Jacek Kot, Pierre Lafère
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557101/immersion-pulmonary-oedema-in-a-healthy-diver-not-exposed-to-cold-or-strenuous-exercise
#13
Olivier Castagna, Sébastien de Maistre, Bruno Schmid, Delphine Caudal, Jacques Regnard
In healthy divers, the occurrence of immersion pulmonary oedema (IPE) is commonly caused by contributory factors including strenuous exercise, cold water and negative-pressure breathing. Contrary to this established paradigm, this case reports on a 26-year-old, well-trained combat swimmer who succumbed to acute IPE during static immersion in temperate (21°C) water, while using a front-mounted counterlung rebreather. The incident occurred during repeated depth-controlled ascent practice at the French military diving school...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557100/vomiting-and-aspiration-of-gastric-contents-a-possible-life-threatening-combination-in-underwater-diving
#14
František Novomeský, Martin Janík, Michal Hájek, Jozef Krajčovič, Lubomír Straka
Vomiting and aspiration of gastric contents into the airways and lungs is a common and well-known clinicopathological entity. This phenomenon might also occur in underwater diving, where it can lead to life-threatening or fatal situations. This article presents two incidents involving diving-related vomiting with associated aspiration of gastric contents. One case, a 39-year-old commercial diver using a full-face diving mask, was fatal and the other was a 33-year-old, female recreational scuba diver in whom underwater vomiting was complicated by pulmonary aspiration of a solid foreign body (a peanut) into the right lower lobe bronchus...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557099/hyperbaric-oxygen-treatment-in-thromboangiitis-obliterans-a-retrospective-clinical-audit
#15
Dogus Hemsinli, Gokalp Altun, Safiye Tuba Kaplan, Furkan Yildirim, Gamze Cebi
INTRODUCTION: Wounds refractory to standard treatment in patients with thromboangiitis obliterans (TAO, Buerger's disease) are associated with amputation, other morbidity and mortality. The purpose of this study was to investigate the effect of hyperbaric oxygen treatment (HBOT) in patients with TAO. MATERIALS AND METHODS: Ninety-seven patients with TAO with ischaemic wounds treated between January 2007 and July 2016 were included in this dual-centre, non-randomised, retrospective study...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557098/challenges-in-profiling-australian-scuba-divers-through-surveys
#16
John Lippmann, David McD Taylor, Christopher Stevenson, Joanne W Williams
INTRODUCTION: This study aimed to compare the results from three Australian scuba diver surveys. As the surveys differed in recruitment methods, the expectation was that respondents would differ in some important characteristics. METHODOLOGY: Anonymous, online, cross-sectional surveys of the demographics, health, diving practices and outcomes were distributed to: (1) Divers Alert Network Asia-Pacific (DAN AP) members; (2) Professional Association of Diving Instructors (PADI) Asia-Pacific members; and (3) divers who had received any PADI non-leadership certification within the previous four years...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557097/modern-assessment-of-pulmonary-function-in-divers-cannot-rely-on-old-reference-values
#17
Thijs T Wingelaar, Paul Clarijs, Pieter-Jan Am van Ooij, Dave Aa Koch, Rob A van Hulst
INTRODUCTION: Pulmonary function testing (PFT) is an important part of dive medical examinations. Depending on the standard used to assess fitness to dive, different reference sets and fixed cut-off points are used. Reference values are part of an ongoing debate regarding the validity and accuracy related to different age groups, sex and ethnic backgrounds. The Global Lung Initiative (GLI) has provided an all-age reference set which corrects for sex and ethnicity (GLI-2012); this has had substantial impact on pulmonary medicine...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557096/long-term-changes-in-spirometry-in-occupational-divers-a-10-25-year-audit
#18
Christopher Sames, Desmond F Gorman, Simon J Mitchell, Lifeng Zhou
AIM: To determine whether long-term engagement in occupational diving causes significant changes in spirometric measurements. METHOD: All divers with adequate spirometric records spanning at least 10 years were identified from the New Zealand occupational diver database. Changes in lung function over time were compared with normative values derived using published prediction equations. Any significant changes were tested for correlation with age, duration of occupational diving, gender, smoking history and body mass index (BMI)...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557095/transcutaneous-oximetry-variability-in-normal-values-for-the-upper-and-lower-limb
#19
Denise F Blake, Derelle A Young, Lawrence H Brown
INTRODUCTION: Published normal transcutaneous oxygen partial pressures (Ptc O2 ) for the chest and lower limb have defined tissue hypoxia as a value of < 40 mmHg (< 30 mmHg in some patients, < 50 mmHg in others). AIM: To determine 'normal' Ptc O2 for the upper and lower limb in healthy, non-smoking adults using the Radiometer® TCM400 with tc Sensor E5250. METHOD: Thirty-two volunteers had transcutaneous oxygen measurements (TCOM) performed on the chest, upper and lower limbs breathing air, with leg then arm elevated and whilst breathing 100% oxygen...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241238/hyperbaric-oxygen-associated-seizure-leading-to-stroke
#20
Jordan M Warchol, Jeffrey S Cooper, Thomas S Diesing
Oxygen toxicity seizures are a well-known complication of hyperbaric oxygen treatment (HBOT). Until now, there have not been any reported cases of an acute ischaemic event (stroke) as the result of a HBOT-associated oxygen toxicity seizure. We report an event in which a seizure and stroke occurred together and consider that the stroke may have been caused by seizure-induced demand ischaemia. This challenges the generally held view that oxygen toxicity seizures in the clinical hyperbaric setting are benign. A discussion of the literature on the subject of seizure-induced brain injury is included...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
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