Abstract - doi 10.28920/dhm55.3.226-230
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
The effect of hyperbaric oxygen therapy on lesion size in early-stage femoral head avascular necrosis
Mehmet Ekici1, Eyüp Can Mazlum2, Mahmut Burak Laçin3, Mehmet Emin Akçin4, Ali Eray Günay5, Firat Ozan6
1 Yozgat City Hospital, Orthopaedic and Traumatology Clinic, Yozgat, Türkiye
2 Medical Park Gebze Hospital, Orthopaedic and Traumatology Clinic, Kocaeli, Türkiye
3 Besni State Hospital, Radiology Clinic, Adıyaman, Türkiye
4 Oxigap Hyperbaric Oxygen Center, Undersea and Hyperbaric Medicine Clinic, Gaziantep, Türkiye
5 Private Erciyes Hospital, Orthopaedic and Traumatology Clinic, Kayseri, Türkiye
6 Kayseri City Education and Research Hospital, Orthopaedic and Traumatology Clinic, Kayseri, Türkiye
Corresponding author: Dr Mehmet Ekici, Yozgat City Hospital, Orthopaedic and Traumatology Clinic, Yozgat, Türkiye
ORCiD: 0000-0003-4336-8596
Keywords
Bone necrosis; Hyperbaric medicine; Hyperbaric research; Orthopaedics
Abstract
(Ekici M, Mazlum EC, Laçin MB, Akçin ME, Günay AE, Ozan F. The effect of hyperbaric oxygen therapy on lesion size in early-stage femoral head avascular necrosis. Diving and Hyperbaric Medicine. 2025 30 September;55(3):226−230. doi: 10.28920/dhm55.3.226-230. PMID: 40986917.)
Introduction: Femoral head avascular necrosis (AVN) is a common orthopaedic condition that occurs when intraosseous microcirculation is compromised. Hyperbaric oxygen therapy (HBOT) increases tissue oxygen concentration, reduces oedema, stimulates angiogenesis, lowers intraosseous pressure, and enhances microcirculation. The aim of this study was to evaluate the effectiveness of HBOT in early femoral head AVN based on magnetic resonance imaging (MRI) findings.
Methods: A total of 37 hips from 25 patients with Ficat Stage 1−2 femoral head AVN, followed between 2018 and 2021 and receiving HBOT at Kayseri City Training and Research Hospital, were retrospectively included. Thirty HBOT sessions of 90 minutes each were administered at 243 kPa pressure (2.4 atmospheres absolute) with 100% oxygen breathing, along with a weight-bearing restriction protocol.
Results: There were 20 females and five males. The mean (standard deviation) age was 46.9 (9.5). In pre-treatment MRI imaging, the mean lesion size was 29.87 (22.64) cm3 in 20 right hips and 28.84 (14.95) cm3 in 17 left hips (P = 0.183). At the second month after treatment, the lesion size was 12.39 (11.26) cm3 in 20 right hips and 21.81 (13.56) cm3 in 17 left hips (P < 0.001). The mean pre-post differences for the right and left hips was 17.48 (21.15) cm3 and 7.02 (5.95) cm3 respectively (both P < 0.001).
Conclusions: Femoral head AVN is a progressive disease, with femoral head collapse exceeding 40% in a five-year follow-up. This study demonstrated a reduction in lesion size associated with HBOT in early stage femoral head AVN. In our opinion, HBOT is an integral part of the treatment for early-stage femoral avascular necrosis.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.231-235
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Evaluation of bacterial survival on inert surfaces in a hyperbaric environment
Laetitia Hendier1, Hervé Soule2, Mohamed Abbas2, Didier Pittet2, Rodrigue Pignel3, Sylvain Boet3
1 Internal Medicine Department, University of Geneva Hospitals, Switzerland
2 Infection Control Programme and WHO Collaborating Centre on Antimicrobial Resistance and Infection Prevention and Control, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
3 Diving and Hyperbaric Medicine Unit, Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
Corresponding author: Dr Laetitia Hendier, Internal Medicine Department, The University of Geneva Hospitals, rue Gabrielle-Perret-Gentil 4, 1202 Geneva, Switzerland
ORCiD: 0009-0000-2276-4712
Keywords
Bacteria; Hyperbaric oxygen; Infection control; Microbiology; Pressure chamber; Safety
Abstract
(Hendier L, Soule H, Abbas M, Pittet D, Pignel R, Boet S. Evaluation of bacterial survival on inert surfaces in a hyperbaric environment. Diving and Hyperbaric Medicine. 2025 30 September;55(3):231−235. doi: 10.28920/dhm55.3.231-235. PMID: 40986918.)
Introduction: Surface cleaning and hand hygiene within hyperbaric chambers are challenging because of the risk of fire with currently used products containing alcohol or glycerine. This study aimed to investigate if hyperbaric conditions could have inhibitory effects on bacteria present on inert materials.
Methods: We deposited Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) on inert materials in an experimental chamber (Comex1200Alu) and compressed the chamber environment with air (253 kPa, 95 minutes) (referred to as indoor). The control was contaminated materials placed outside the chamber (referred to as outdoor). We chose inert materials including plastic, metal, and seat upholstery (imitation leather). We measured bacterial growth and survival and compared the groups using a Student’s t-test.
Results: Regardless of the surface types tested, there were no significant differences in bacterial reduction between indoor and outdoor conditions for either E. coli or S. aureus and any of the materials (P > 0.05).
Conclusions: We found that pressurised air (253 kPa for 95 minutes) has neither proliferative nor bactericidal action on S. aureus and E. coli colonies deposited on inert surfaces compared to those present outside a hyperbaric chamber in normobaric air conditions.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.236-245
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Vestibular rehabilitation and recovery in divers with inner ear decompression sickness: a case series
Rosanna J Stokes1, 2, Doug Watts2, Gary Smerdon2, Stephen D Hall1, Lisa Bunn1, Jonathan Marsden1
1 Brain Research and Imaging Centre, University of Plymouth, Plymouth, UK
2 DDRC Healthcare, Science Park, Plymouth, UK
Corresponding author: Dr Rosanna J Stokes, DDRC Healthcare, Science Park, Plymouth, UK
ORCiD: 0009-0006-4501-0634
Keywords
ENT; Fitness to dive; Scuba diving; Sharpened Romberg test; Vertigo
Abstract
(Stokes RJ, Watts D, Smerdon G, Hall SD, Bunn L, Marsden J. Vestibular rehabilitation and recovery in divers with inner ear decompression sickness: a case series. Diving and Hyperbaric Medicine. 2025 30 September;55(3):236−245. doi: 10.28920/dhm55.3.236-245. PMID: 40986919.)
Introduction: The mechanism of injury and recovery of divers with inner ear decompression sickness (IEDCS) is not well understood and there is no consensus regarding management following recompression treatment. Given the rare occurrence, divers are not routinely offered the standard therapies that patients with other acute vestibular disorders may be offered such as vestibular rehabilitation.
Methods: This is an observational case series of 13 divers presenting acutely with IEDCS to DDRC Healthcare in Plymouth, UK between July 2021 and January 2024. Vestibular and balance tests were undertaken to aid the treating dive physician in the diagnosis and management of the divers with both hyperbaric oxygen therapy and customised vestibular rehabilitation.
Results: Average values for vertical perception, posturography, dynamic gait index and patient-reported outcomes measures improved by discharge and at the three month follow up despite 67% showing an ongoing positive head impulse test or nystagmus in the dark on videonystagmography at follow up.
Conclusions: Divers should be warned that despite symptom resolution or minimal residual symptoms post-IEDCS there is a high rate of deficit evident on vestibular testing, and this, alongside investigation for a right to left cardiac shunt, should be a major consideration when considering returning to diving. For the clinician, a stopwatch timed Sharpened Romberg’s test appears to be a reasonable method for monitoring progress of balance stabilisation during the treatment period. Early initiation of vestibular rehabilitation exercises should be considered for all divers with IEDCS.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi: 10.28920/dhm55.3.246-253
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
The role and efficacy of ECG screening in assessing fitness to dive in military divers: implications of sports medicine standards
Bas L van der Kooi1, Alef DM Hoedemaeker1, Lysette N Broekhuizen2, Pieter-Jan AM van Ooij1, Thijs T Wingelaar1
1 Royal Netherlands Navy, Diving and Submarine Medical Center, Rijkszee and Marinehaven, 1780 CA Den Helder, the Netherlands
2 Ministry of Defense, Central Military Hospital, Utrecht, the Netherlands
Corresponding author: Dr Thijs T Wingelaar, Royal Netherlands Navy, Diving and Submarine Medical Center, Rijkszee and Marinehaven, 1780 CA Den Helder, the Netherlands
ORCiD: 0000-0001-7740-7392
Keywords
Cardiac; Cardiovascular; Diving; Electrocardiography; Health; Investigations
Abstract
(van der Kooi BL, Hoedemaeker ADM, Broekhuizen LN, van Ooij PJAM, Wingelaar TT. The role and efficacy of ECG screening in assessing fitness to dive in military divers: implications of sports medicine standards. Diving and Hyperbaric Medicine. 2025 30 September;55(3):246−253. doi: 10.28920/dhm55.3.246-253. PMID: 40986920.)
Introduction: Diving necessitates significant physiological adaptations, particularly within the cardiopulmonary system. Resting electrocardiograms (ECGs) are widely used in fitness to dive assessments, but their effectiveness in healthy young divers remains unclear. This study assessed the impact of applying sports medicine ECG criteria compared to traditional clinical standards, aiming to reduce (unnecessary) referrals to a cardiologist without compromising diver safety.
Methods: In this retrospective study covering 10 years, ECGs from Royal Netherlands Navy divers were analysed. Abnormal ECGs identified by clinical criteria between 2010 and 2019 were re-evaluated using international sports medicine ECG criteria. A control group of normal ECGs was matched based on demographic factors. Statistical analyses were performed using Pearson’s chi-squared and Fisher’s exact test, with significance set at P < 0.05.
Results: Of a total of 3,020 ECGs, 156 were classified as abnormal by clinical criteria. Reassessment using sports medicine standards reduced the number requiring further investigation by 85.9%. In the control group, 1.0% of previously unremarkable ECGs were identified as requiring further investigation upon reassessment. Conduction disorders and rhythm disturbances were the most common findings.
Conclusions: The findings of this study suggest that the application of sports medicine ECG interpretation criteria effectively reduces the number of ECGs requiring further investigation, thereby minimising referrals and associated costs. These results advocate for a re-evaluation of routine ECG screening practices in fitness to dive assessments in military divers, promoting a more tailored approach for this specific group.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.254-261
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Assessing dive fitness in individuals with autism spectrum disorder
Abraham L Querido1,2, Thijs T Wingelaar2,3
1 Praktijk Querido, Hilversum, the Netherlands
2 Dutch Society of Diving and Hyperbaric Medicine, Bilthoven, the Netherlands
3 Royal Netherlands Navy, Diving Medical Center, Den Helder, the Netherlands
Corresponding author: Dr Abraham L Querido, Praktijk Querido, Veerstraat 25, 1211 HJ Hilversum the Netherlands
ORCiD: 0009-0001-1988-0832
Keywords
Fitness-to-dive; Mental health; Psychiatry; Scuba
Abstract
(Querido AL, Wingelaar TT. Assessing dive fitness in individuals with autism spectrum disorder. Diving and Hyperbaric Medicine. 2025 30 September;55(3):254−261. doi: 10.28920/dhm55.3.254-261. PMID: 40986921.)
Scuba diving requires situational awareness, cognitive flexibility, and the ability to adapt to changing conditions. For individuals with autism spectrum disorder (ASD), these demands may pose unique challenges due to differences in executive functioning, sensory processing, and social cognition. This article explores the key considerations in assessing fitness to dive in individuals with ASD, including the impact of comorbidities, medication use, and cognitive abilities on diving safety. To provide a broader perspective, we examine research on ASD and high-risk activities such as driving, where similar cognitive and decision-making challenges exist. Additionally, we discuss the role of neuropsychological assessments in evaluating a diver’s cognitive fitness and the limited but emerging evidence on scuba diving interventions for individuals with ASD. While ASD is not an absolute contraindication to diving, a careful, individualised assessment is essential to determine suitability. This review aims to provide guidance for diving professionals and medical examiners in making informed decisions regarding ASD and scuba diving.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract doi 10.28920/dhm55.3.262-270
The full article is available here.
Revised guideline for central nervous system oxygen toxicity exposure limits when using an inspired PO2 of 1.3 atmospheres
Joseph Hoyt1, F Gregory Murphy2, Neal W Pollock3,4, Dawn Kernagis5, Nicholas Bird6, Michael Menduno7, John Bright8, Simon J Mitchell9,10,11
1 NOAA Diving Program, National Oceanographic and Atmospheric Administration, Seattle, WA, USA
2 Navy Experimental Diving Unit, Panama City, FL, USA
3 Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
4 Service de médecine hyperbare, Centre de médecine de plongée du Québec, Levis, Québec, Canada
5 DEEP Research Inc., Miami, FL, USA
6 Department of Hyperbaric Medicine, Virginia Mason Hospital, Seattle, WA, USA
7 InDEPTH Magazine, High Springs, FL, USA
8 CPC Inc., San Diego, CA, USA
9 Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
10 Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand
11 Slark Hyperbaric Unit, North Shore Hospital, Auckland, New Zealand
Corresponding author: Professor Simon J Mitchell, Department of Anaesthesiology, University of Auckland, Private Bag 92019, Auckland, New Zealand
Keywords
Oxygen clock; Rebreathers; Risk; Seizures; Technical diving
Abstract
(Hoyt J, Murphy G, Pollock NW, Kernagis D, Bird N, Menduno M, Bright J, Mitchell SJ. Revised guideline for central nervous system oxygen toxicity exposure limits when using an inspired PO2 of 1.3 atmospheres. Diving and Hyperbaric Medicine. 2025 30 September;55(3):262−270. doi: 10.28920/dhm55.3.262-270. PMID: 40986922.)
Technical and scientific divers breathing gases delivering hyperbaric pressures of inspired oxygen may be at risk of developing cerebral oxygen toxicity which can manifest as a seizure with little or no warning. The principle preventative strategy is adherence to time limits based on inspired PO2 levels promulgated in 1991. These limits had their origins in US Navy studies of exposures to higher inspired PO2s than are typically utilised by modern divers. Indeed, the duration limits for inspired PO2s in the range typically utilised by technical divers (≤ 1.3–1.4 atm) have relatively little experimental provenance. Contemporary technical dives often involve decompression durations that result in breaches of these limits, and anecdotally, this common occurrence seems associated with a low risk of cerebral oxygen toxicity. A committee of experts recently sought experimental evidence that might support an adjustment to the recommended duration limits for typical technical dives. Such evidence exists only for an inspired PO2 of 1.3 atm, which is a common default in use of constant PO2 rebreather devices. The (1991) limit for a single exposure to an inspire PO2 of 1.3 atm is 180 min with a 24-hour maximum of 210 min. Recent studies provide reassurance that dives with an inspired PO2 of 1.3 atm consisting of up to 240 min of working dive activity followed by up to 240 min of resting decompression are associated with an acceptably low risk of cerebral oxygen toxicity. This recommendation was promulgated and endorsed at a recent workshop convened by the National Oceanographic and Atmospheric Administration (NOAA) involving technical and scientific divers.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.271-274
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Serial chest computed tomography imaging in a freediver with a case of pulmonary barotrauma of descent (lung squeeze) showing the time course of resolution
Madeleine E Wagner1, Elaine Yu2, Anna Lussier1, Nicole Lin3, Henry Guo4, Peter Lindholm1,2
1 University of California San Diego School of Medicine, San Diego, USA
2 Department of Emergency Medicine, University of California at San Diego, San Diego, USA
3 Division of Thoracic Surgery, Department of Cardiothoracic Surgery, Stanford University, School of Medicine, Stanford, USA
4 Department of Radiology, Stanford University, Stanford, USA
Corresponding author: Dr Madeleine Wagner, University of California San Diego School of Medicine, San Diego, USA
ORCiD: 0009-0005-5424-4267
Keywords
Breath-hold diving; Diving medicine; Hemoptysis; Pulmonary oedema; Radiological imaging
Abstract
(Wagner ME, Yu E, Lussier A, Lin N, Guo H, Lindholm P. Serial chest computed tomography imaging in a freediver with a case of pulmonary barotrauma of descent (lung squeeze) showing the time course of resolution. Diving and Hyperbaric Medicine. 2025 30 September;55(3):271−274. doi: 10.28920/dhm55.3.271-274. PMID: 40986923.)
Freedivers can suffer respiratory symptoms indicative of freediving induced pulmonary syndrome (FIPS). Aetiology includes immersion pulmonary oedema and barotrauma of descent in the tracheobronchial or pulmonary parenchyma, also colloquially called ‘squeeze’. The pathophysiology and natural history are still largely unknown. This case report describes a freediver who developed haemoptysis following a 49 m personal best constant weight bi-fin dive, presenting with two episodes of haemoptysis within 24 hours post-dive. This style of diving entails finning down to the desired depth, turning with a single pull on the rope, and then finning up to the surface without use of the arms. The diver exhibited no other symptoms and remained haemodynamically stable. Computed tomography (CT) imaging performed two days post-dive showed ground-glass opacities in the right upper and middle lobes. Treatment involved hospitalisation, high-dose corticosteroids, and antibiotics. Follow-up CT scans post-dive revealed almost complete resolution (six days) followed by complete resolution of pulmonary abnormalities (21 days). This case is unique for its documentation of changes in lung findings over three sequential CT scans, providing a timeline of anatomical recovery. Serial CT scanning would not be routinely recommended from a radiation safety perspective but yielded interesting data into the time course of this trauma. The findings raise questions about the underdiagnosis of squeeze injuries, as this diver displayed minimal symptoms despite radiographic evidence of ground-glass opacities. This case highlights the need for standardised imaging and management protocols, as well as further research into the natural history and clinical significance of FIPS.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.275-279
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Hyperbaric oxygen therapy for late onset dropped head syndrome following mantle field radiation therapy for Hodgkin lymphoma: a case report and literature review
Shane A Rosenzweig1,2, Stephen R Thompson3,4, Michael H Bennett4,5
1 Department of Radiation Oncology, Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, Australia
2 Central Clinical School, University of Sydney, Sydney, Australia
3 Department of Radiation Oncology, Prince of Wales Hospital, Sydney, Australia
4 Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
5 Department of Diving and Hyperbaric Medicine, Prince of Wales Hospital, Sydney, Australia
Corresponding author: Dr Shane A Rosenzweig, Crown Princess Mary Cancer Centre, 166-174 Hawkesbury Rd, Westmead, NSW 2145, Australia
ORCiD: 0009-0007-1891-5339
Keywords
Case reports; Malignancy; Musculo-skeletal; Radiotherapy; Treatment sequelae
Abstract
(Rozenzweig SA, Thompson SR, Bennett MH. Hyperbaric oxygen therapy for late onset dropped head syndrome following mantle field radiation therapy for Hodgkin lymphoma: a case report and literature review. Diving and Hyperbaric Medicine. 2025 30 September;55(3):275−279. doi: 10.28920/dhm55.3.275-279. PMID: 40986924.)
The authors present the first documented case of the apparent effective use of hyperbaric oxygen therapy (HBOT) for the treatment of radiation-induced dropped head syndrome (DHS). DHS is a condition associated with progressive and often severe weakness of cervical paraspinal muscles, especially the neck extensors. This results in loss of horizontal gaze and in advanced cases causes a chin-on-chest deformity. Radiation-induced DHS is a rare, primarily late-term complication first described in patients treated with mantle field radiotherapy for Hodgkin lymphoma, though there is an increasing body of literature demonstrating a wide range of presentations. A 59-year-old man with a history of stage 2A Hodgkin lymphoma 34 years prior had been treated with extended field radiotherapy, including mantle radiotherapy, totalling 40 Gy in 19 fractions. He presented with three years of progressive neck extension weakness with associated stiffness and intermittent dysphagia. The patient underwent 60 sessions of HBOT, in conjunction with physiotherapy and thiamine replacement and demonstrated improvement of his postural maintenance and dysphagia. His improved function was maintained at three years follow-up. We discuss the literature on the management of this rare condition, including the rationale for using HBOT which is well documented for the treatment of other late-term radiotherapy side effects. This case adds to the increasing literature on the management of DHS and describes a novel approach to the management of this often-debilitating condition.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.280-283
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Periorbital emphysema after a dry hyperbaric chamber exposure
Ping Wu1, Kin Bong Tang2, Wing Wa Yan2
1 Tuen Mun Hospital, Hong Kong
2 Pamela Youde Nethersole Eastern Hospital, Hong Kong
Corresponding author: Dr Ping Wu, Tuen Mun Hospital, Tsing Chung Koon Road, Hong Kong
ORCiD: 0000-0001-6215-4847
Keywords
Case report; Complications; Hyperbaric oxygen; Hyperbaric medicine; Ophthalmology; Side effects
Abstract
(Wu P, Tang KB, Yan WW. Periorbital emphysema after a dry hyperbaric chamber exposure. Diving and Hyperbaric Medicine. 2025 30 September;55(3):280−283. doi: 10.28920/dhm55.3.280-283. PMID: 40986925.)
We report a case of a patient developing extensive periorbital, facial, and neck emphysema during hyperbaric oxygen treatment for his facial osteoradionecrosis after sequestrectomy. Hyperbaric physicians should be alert for the potential development of this complication during the treatment and have a contingency plan.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.284-288
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Hyperbaric oxygen treatment of neonates: a case series
Gizem Kavram1, Beril Yasa1, Meltem Bor1, Leyla Bilgin1, Elmas Zeynep Ince1, Bengusu Mirasoglu2, Emine Asuman Coban1
1 Department of Pediatrics, Division of Neonatology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkiye
2 Department of Underwater and Hyperbaric Medicine, Istanbul University Istanbul Medical Faculty, Istanbul, Turkiye
Corresponding author: Dr Gizem Kavram, Department of Pediatrics, Division of Neonatology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkiye
ORCiD: 0000-0002-2014-3223
Keywords
Case reports; Hyperbaric medicine; Newborn; Thrombosis; Wound healing
Abstract
(Kavram G, Yasa B, Bor M, Bilgin L , Ince EZ, Mirasoglu B, Coban EA. Hyperbaric oxygen treatment of neonates: a case series. Diving and Hyperbaric Medicine. 2025 30 September;55(3):284−288. doi: 10.28920/dhm55.3.284-288. PMID: 40986926.)
Hyperbaric oxygen therapy (HBOT) administers oxygen under high pressure, mainly for decompression illness, carbon monoxide intoxication, wound healing, infections, and acute peripheral arterial ischaemia. There has been limited use in newborn infants. This case series aims to highlight the potential role of HBOT in management of rare and challenging conditions encountered in the neonatal period. Although HBOT is widely available, its application in newborns remains limited and not well established. We present three neonatal cases: acute peripheral ischaemia; vascular compromise due to thrombosis and compartment syndrome; and a non-healing surgical wound following omphalocele repair. We aim to emphasise the potential clinical benefit and discuss the safety profile of HBOT in select life or limb threatening neonatal pathologies. These cases demonstrate that HBOT, when use as an adjunctive therapy, may contribute to tissue salvage and overall improved outcomes in critically ill neonates. Our intention is to raise awareness and contribute to the limited literature regarding neonatal HBOT, particularly in contexts where usual treatment options are insufficient.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Abstract - doi 10.28920/dhm55.3.289-293
The full article is currently under embargo for 12 months and will be made available on our website and PMC after this period. If you would like to access the article before it becomes publicly available, you can purchase it for personal use directly on our website. Alternatively, you may join SPUMS or EUBS to gain access to the entire issue.
Localised tissue necrosis from marine puncture injury: first aid, definitive management and review of the literature
Deon A Viljoen1, Jessica Andrews2
1 Occupational Underwater Medicine, NSW, Australia
2 Molecular Biotechnology, Joondalup, WA, Australia
Corresponding author: Dr Deon Viljoen, Occupational Underwater Medicine, 39A Pell Street, Merewether, NSW, 2291, Australia
ORCiD: 0009-0000-0124-6350
Keywords
Case reports; First aid; Marine envenomation; Microbiology; Necrotising infections; Risk management; Surgery
Abstract
(Viljoen DA, Andrews J. Localised tissue necrosis from marine puncture injury: first aid, definitive management and review of the literature. Diving and Hyperbaric Medicine. 2025 30 September;55(3):289−293. doi: 10.28920/dhm55.3.289-293. PMID: 40986927.)
We discuss a case of tropical marine envenomation from an unidentified marine creature via a penetrating injury to the left ring finger resulting in localised tissue necrosis. We present an evidence-based review of marine puncture wounds including first aid, hot water immersion therapy, antibiotic selection and definitive management.
Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.