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Decompression illness

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https://www.readbyqxmd.com/read/28900861/acute-kidney-injury-caused-by-decompression-illness-successfully-treated-with-hyperbaric-oxygen-therapy-and-temporary-dialysis
#1
Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...
September 12, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28880140/-diving-accident-induced-arterial-gas-embolism
#2
P D Nijk, T P van Rees Vellinga, J M van Lieshout, M I Gaakeer
BACKGROUND: During scuba diving, nitrogen dissolves into the body tissues due to elevated pressure under water. During a sudden drop in pressure due to a rapid return to the water surface, arterial gas embolism can arise from pulmonary barotrauma. In a later phase, nitrogen bubbles can also arise in the venous circulation (decompression sickness). Arterial bubbles can incur vascular damage, obstruction, hypoxia and infarction. CASE DESCRIPTION: A 53-year-old healthy sport diver presented at the emergency department in a hypovolemic shock with progressive paresis of all the extremities...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28868599/diving-with-pre-existing-medical-conditions
#3
John Lippmann, David McD Taylor, Christopher Stevenson, Jo Williams, Simon J Mitchell
INTRODUCTION: This is the second report based on a survey of Divers Alert Network Asia-Pacific (DAN AP) members who dive with cardiovascular and respiratory conditions and diabetes. It examines the medical management of the divers' conditions, any diving modifications used to mitigate the risk and outcomes. METHODOLOGY: An online cross-sectional survey was sent to 833 divers who had declared a targeted medical condition when applying for DAN AP membership between July 2009 and August 2013...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28861003/nanobubbles-form-at-active-hydrophobic-spots-on-the-luminal-aspect-of-blood-vessels-consequences-for-decompression-illness-in-diving-and-possible-implications-for-autoimmune-disease-an-overview
#4
REVIEW
Ran Arieli
Decompression illness (DCI) occurs following a reduction in ambient pressure. Decompression bubbles can expand and develop only from pre-existing gas micronuclei. The different hypotheses hitherto proposed regarding the nucleation and stabilization of gas micronuclei have never been validated. It is known that nanobubbles form spontaneously when a smooth hydrophobic surface is submerged in water containing dissolved gas. These nanobubbles may be the long sought-after gas micronuclei underlying decompression bubbles and DCI...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28828195/critically-ill-patients-and-gut-motility-are-we-addressing-it
#5
REVIEW
Alfredo Vazquez-Sandoval, Shekhar Ghamande, Salim Surani
Gastrointestinal (GI) dysmotility is a common problem in the critically ill population. It can be a reflection and an early sign of patient deterioration or it can be an independent cause of morbidity and mortality. GI dysmotility can be divided for clinical purposes on upper GI dysmotility and lower GI dysmotility. Upper GI dysmotility manifests by nausea, feeding intolerance and vomiting; its implications include aspiration into the airway of abdominal contents and underfeeding. Several strategies to prevent and treat this condition can be tried and they include prokinetics and post-pyloric feeds...
August 6, 2017: World Journal of Gastrointestinal Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28783886/cerebrospinal-vascular-diseases-misdiagnosed-as-decompression-illness-the-importance-of-considering-other-neurological-diagnoses
#6
Kiyotaka Kohshi, Yoshitaka Morimatsu, Hideki Tamaki, Yukio Murata, Katsuko Kohshi, Tatsuya Ishitake, Petar J Denoble
The diagnosis of decompression illness (DCI), which is based on a history of decompression and clinical findings, can sometimes be confounded with other vascular events of the central nervous system. The authors report three cases of divers who were urgently transported to a hyperbaric facility for hyperbaric oxygen treatment of DCI which at admission turned out to be something else. The first case, a 45-year-old experienced diver with unconsciousness, was clinically diagnosed as having experienced subarachnoid hemorrhage, which was confirmed by CT scan...
July 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28780148/intraabdominal-hypertension-abdominal-compartment-syndrome-and-the-open-abdomen
#7
REVIEW
William Kirke Rogers, Luis Garcia
Abdominal compartment syndrome (ACS) is the end point of a process whereby massive interstitial swelling in the abdomen or rapid development of a space-filling lesion in the abdomen (such as ascites or a hematoma) leads to pathologically increased pressure. This results in so-called intraabdominal hypertension (IAH), causing decreased perfusion of the kidneys and abdominal viscera and possible difficulties with ventilation and maintenance of cardiac output. These effects contribute to a cascade of ischemia and multiple organ dysfunction with high mortality...
August 2, 2017: Chest
https://www.readbyqxmd.com/read/28777907/elimination-of-ct-detected-gas-bubbles-derived-from-decompression-illness-with-abdominal-symptoms-after-a-short-hyperbaric-oxygen-treatment-in-a-monoplace-chamber-a-case-report
#8
Takuya Oyaizu, Mitsuhiro Enomoto, Toshihide Tsujimoto, Yasushi Kojima, Atsushi Okawa, Kazuyoshi Yagishita
We report the case of a 54-year-old male compressed-air worker with gas bubbles detected by computed tomography (CT). He had complained of strong abdominal pain 30 minutes after decompression after working at a pressure equivalent to 17 meters of sea water for three hours. The initial CT images revealed gas bubbles in the intrahepatic portal vein, pulmonary artery and bilateral femoral vein. After the first hyperbaric oxygen treatment (HBO₂ at 2.5 atmospheres absolute/ATA for 150 minutes), no bubbles were detected on repeat CT examination...
March 2017: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28777522/recurrent-cutaneous-decompression-illness-after-pfo-device-implantation-a-case-report
#9
Martin Vanden EEde
It is well known that patency of the foramen ovale (PFO) is a risk factor for decompression illness (DCI) in scuba divers, even if they adhere to the currently accepted and used decompression tables (termed "an undeserved hit"). The correction of the PFO through percutaneous closure after DCI is an ongoing discussion. We describe a case of a diver who redeveloped a cutaneous DCI due to a recurrent PFO after initial treatment with an occluder device four years earlier.
November 2016: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
https://www.readbyqxmd.com/read/28759427/negative-pressure-wound-therapy-for-patients-with-complex-abdominal-wounds
#10
Zhi Wang, Ming Bai, Xiao Long, Ru Zhao, Xiaojun Wang
The combination of open abdominal wounds and intra-abdominal infections is challenging to treat and often results in critical illness associated with high mortality. OBJECTIVE: The aim of this study is to evaluate the feasibility of using negative pressure wound therapy (NPWT) to manage complex abdominal wounds and summarize relevant treatment experiences. MATERIALS AND METHODS: A retrospective analysis of records from April 2012 to May 2015 identified 13 hospitalized patients with open abdominal wounds complicated by intra-abdominal infections...
July 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28656350/frequency-of-decompression-illness-among-recent-and-extinct-mammals-and-reptiles-a-review
#11
REVIEW
Agnete Weinreich Carlsen
The frequency of decompression illness was high among the extinct marine "reptiles" and very low among the marine mammals. Signs of decompression illness are still found among turtles but whales and seals are unaffected. In humans, the risk of decompression illness is five times increased in individuals with Patent Foramen Ovale; this condition allows blood shunting from the venous circuit to the systemic circuit. This right-left shunt is characteristic of the "reptile" heart, and it is suggested that this could contribute to the high frequency of decompression illness in the extinct reptiles...
August 2017: Die Naturwissenschaften
https://www.readbyqxmd.com/read/28641324/treatment-preferences-for-decompression-illness-amongst-singapore-dive-physicians
#12
Valerie Huali Tan, Kenneth Chin, Aravin Kumar, Jeremiah Chng, Chai Rick Soh Rick Soh
INTRODUCTION: Owing to the scarcity of randomized controlled trials to guide treatment for decompression illness (DCI), there are many unanswered questions about its management. Apart from reviews and expert opinion, surveys that report practice patterns provide information about useful management strategies. Hence, this study aimed to identify current treatment preferences for DCI amongst diving physicians in Singapore. METHODS: An anonymous web-based questionnaire was sent to known diving physicians in Singapore...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28641322/scuba-diving-and-otology-a-systematic-review-with-recommendations-on-diagnosis-treatment-and-post-operative-care
#13
REVIEW
Devon M Livingstone, Kristine A Smith, Beth Lange
Scuba diving is a popular recreational and professional activity with inherent risks. Complications related to barotrauma and decompression illness can pose significant morbidity to a diver's hearing and balance systems. The majority of dive-related injuries affect the head and neck, particularly the outer, middle and inner ear. Given the high incidence of otologic complications from diving, an evidence-based approach to the diagnosis and treatment of otic pathology is a necessity. We performed a systematic and comprehensive literature review including the pathophysiology, diagnosis, and treatment of otologic pathology related to diving...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28562473/trends-in-utilization-and-cost-of-cervical-spine-surgery-using-the-national-inpatient-sample-database-2001-to-2013
#14
Caterina Y Liu, Corinna C Zygourakis, Seungwon Yoon, Tamara Kliot, Christopher Moriates, John Ratliff, R Adams Dudley, Ralph Gonzales, Praveen V Mummaneni, Christopher P Ames
STUDY DESIGN: A retrospective review. OBJECTIVE: The aim of this study was to determine national rates of cervical spine surgery and to examine factors that underlie cost variation. SUMMARY OF BACKGROUND DATA: There has been an increase in the rate and cost of spinal surgery over the past decades, but there is little understanding of the drivers of cost variation at the national level. METHODS: We analyzed 419,830 patients who underwent cervical spine surgery (anterior cervical fusion, posterior cervical fusion, posterior cervical decompression, combined anterior/posterior cervical fusion) for degenerative conditions in the 2001 to 2013 NIS database...
August 1, 2017: Spine
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#15
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28482432/-quick-confirmation-of-nasointestinal-tube-placed-below-pylorus-in-critically-ill-patients-by-duodenal-bulb-ultrasonic-anatomy-locating-method
#16
R Z Ye, X M Fan, R H Sun, F Zhang, L G Wang, Z Zeng, Y Liu, B C Hu, Y X Tu
Objective: To investigate the value of duodenal bulb ultrasonic anatomy locating method quickly confirm nasointestinal tube placed below pylorus in critically ill patients. Methods: A total of 56 critically ill patients with nasointestinal tube posting surgery by blindly inserting method were collected from March 1 st, 2016 to August 1 st, 2016 in the Department of Critical Care Medicine of Zhejiang Provincial People's Hospital.In these patients, the duodenal bulbs were rapidly detected and located by ultrasonic anatomy locating method and at the same time observed whether nasointestinal tube echogram were in them or not...
May 9, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28429454/scuba-diving-patent-foramen-ovale-and-heart-rhythm-disturbances-the-role-of-underwater-holter-monitoring-case-report
#17
Szymon Olędzki, Andrzej Wojtarowicz, Edyta Płońska-Gościniak, Maciej Lewandowski, Jarosław Gorący
Patent foramen ovale (PFO) is thought to be a risk factor for decompression illness (DCI). Catheter-based closure procedure reduces the risk of DCI in selected scuba divers with PFO. Major complication of invasive approach are rare, minor, especially heart rhythm disturbances are reported relatively often. We describe a case of 41-year-old diver, who underwent PFO closure due to recurrent DCI events. Afterward, he experienced no DCI symptoms; however, he complained about feeling of the heart beating during a submersion...
September 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28415099/p594contrast-transthoracic-echocardiography-as-a-gatekeeper-for-patent-foramen-ovale-closure
#18
M Muratori, G Italiano, E Innocenti, L Fusini, M Mapelli, G Tamborini, S Ghulam Ali, P Gripari, A Maltagliati, F Celeste, M Pepi
Background.: The presence of patent foramen ovale (PFO) has been linked to many illness, including cryptogenic stroke, transient ischemic attack, migraine, platypnea-orthodeoxia syndrome and decompression sickness in scuba divers. Transesophageal echocardiography is the gold standard technique for the visualization of atrial septal anatomy, but it is a secondary level exam, not always available, with additional associated costs and not completely free from procedural risks. Standard transthoracic echocardiography (TTE) has a too low sensitivity for PFO screening...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28411929/updates-in-decompression-illness
#19
REVIEW
Neal W Pollock, Dominique Buteau
Decompression sickness and arterial gas embolism, collectively known as decompression illness (DCI), are rare but serious afflictions that can result from compressed gas diving exposures. Risk is primarily determined by the pressure-time profile but is influenced by several factors. DCI can present idiosyncratically but with a wide range of neurologic symptoms. Examination is critical for assessment in the absence of diagnostic indicators. Many conditions must be considered in the differential diagnosis. High-fraction oxygen breathing provides first aid but definitive treatment of DCI is hyperbaric oxygen...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28386273/acute-colonic-pseudo-obstruction-with-feeding-intolerance-in-critically-ill-patients-a-study-according-to-gut-wall-analysis
#20
Chenyan Zhao, Tingbin Xie, Jun Li, Minhua Cheng, Jialiang Shi, Tao Gao, Fengchan Xi, Juanhong Shen, Chun Cao, Wenkui Yu
Objective. To compare the differences between acute colonic pseudo-obstruction (ACPO) with and without acute gut wall thickening. Methods. ACPO patients with feeding tolerance were divided into ACPO with no obvious gut wall thickening (ACPO-NT) group and ACPO with obvious acute gut wall thickening (ACPO-T) group according to computed tomography and abdominal radiographs. Patients' condition, responses to supportive measures, pharmacologic therapy, endoscopic decompression, and surgeries and outcomes were compared...
2017: Gastroenterology Research and Practice
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