2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):240–247 . doi: 10.28920/dhm51.3.240-247. PMID: 34547774.

Comparison of venous, capillary and interstitial blood glucose data measured during hyperbaric oxygen treatment from patients with diabetes mellitus

Carol Baines1, Don Vicendese2,3, David Cooper1, William McGuiness4, Charne Miller4

1 Department of Diving and Hyperbaric Medicine, Royal Hobart Hospital, Tasmania, Australia
2 Department of Mathematics and Statistics, La Trobe University, Melbourne, Victoria, Australia
3 Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia
4 School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia

Corresponding author: Dr Carol Baines, Department of Diving and Hyperbaric Medicine, Royal Hobart Hospital, 48 Liverpool Street, GPO 1061 Hobart, Tasmania 7001, Australia
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Key words
Blood sugar level; Endocrinology; Hyperbaric medicine; Hyperbaric research; Patient monitoring

Abstract
(Baines C, Vicendese D, Cooper PD, McGuiness W, Miller C. Comparison of venous, capillary and interstitial blood glucose data measured during hyperbaric oxygen treatment from patients with diabetes mellitus. Diving and Hyperbaric Medicine. 2021 September 30;51(3):240–247 . doi: 10.28920/dhm51.3.240-247. PMID: 34547774.)
Introduction: Patients undergoing hyperbaric oxygen treatments (HBOT) have been shown to experience a reduction in blood glucose (BG) levels during a treatment. This necessitates frequent assessment of BG levels. Continuous glucose monitoring (CGM) may represent an alternative to the current finger prick monitoring method in-chamber, however, continuous sensor glucose (SG) data has not been validated in situ. The aim was to determine the validity of continuous SG and intermittent BG monitoring with serum BG levels in diabetic patients during HBOT.
Methods: Measurements were obtained (finger prick [capillary sample], CGM [interstitial fluid], and serum [venous sample]) at baseline, and at 30, 60, 90 and 120 minutes during the hyperbaric treatment. Data were analysed by calculating intraclass correlation coefficients (ICC) and using mixed effects linear regression.
Results: The ICC results (n = 10 patients) between the three methods indicated very high and statistically significant absolute agreement at baseline (pre-dive) (ICC = 0.90, 95% CI 0.74−0.97), at 30 minutes (ICC = 0.85, 95% CI 0.61−0.96), 60 minutes (ICC = 0.86, 95% CI 0.58−0.96), 90 minutes (ICC = 0.87, 96% CI 0.63−0.96) and 120 minutes (ICC = 0.90, 95% CI 0.70−0.97). Capillary glucose and CGM SG readings were each within 1 mmol·L-1 on average of the serum glucose reading, with multi-level linear regression finding the average difference between the CGM SG and capillary glucose methods of BG sampling was not statistically significant (P = 0.81).
Conclusions: The CGM SG data were comparable with glucose readings from capillary monitoring. Both CGM and capillary data were consistent with serum values.

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.

Publication Type: Original article


 2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):248–255. doi: 10.28920/dhm51.3.248-255. PMID: 34547775

Long-term infant outcomes after hyperbaric oxygen treatment for acute carbon monoxide poisoning during pregnancy

Kubra Ozgok-Kangal1

1 Department of Undersea and Hyperbaric Medicine, Saglik Bilimleri Universitesi, Gulhane Egitim ve Arastirma Hastanesi, Ankara, Turkey

Corresponding author: Dr Kubra Ozgok-Kangal, Gen Dr Tevfik Saglam Cad. SBÜ-Gülhane Eğitim ve Araştırma Hastanesi, Sualtı Hekimliği ve Hiperbarik Tıp Kliniği, Etlik, Ankara, Turkey, ORCID: 0000-0002-2449-4821.
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Key words
Fetal development; Hyperbaric medicine; Long-term adverse effects; Pregnancy outcome; Pregnancy trimesters

Abstract
(Ozgok-Kangal K. Long-term infant outcomes after hyperbaric oxygen treatment for acute carbon monoxide poisoning during pregnancy. Diving and Hyperbaric Medicine. 2021 September 30;51(3):248–255. doi: 10.28920/dhm51.3.248-255. PMID: 34547775.)
Introduction: Carbon monoxide (CO) poisoning in pregnant women is linked to foetal mortality of 36–67%. This study assessed long-term fetal outcomes following hyperbaric oxygen treatment (HBOT) for acute CO poisoning in pregnant women. The effects of clinical severity parameters and pregnancy trimester were also analysed.
Methods: A retrospective review of 28 pregnant patients who received HBOT for acute CO poisoning between January 2013–June 2016 was made. Adverse events, birth week, birth weight-height, birth complications, and the age of crawling, walking independently, talking (first words) of their children were recorded.
Results: Twenty-eight singleton pregnancies were included. One fetus was dead before HBOT. Three adverse events were reported: abortion, premature birth, and limb malformation. All remaining patients (n = 24) delivered healthy term infants and reported normal neurophysiological development. At final interview the median age of babies was 34 (8–44) months and none had any diagnosed disease. There was no relationship between clinical severity parameters and long-term outcomes. However, the pregnancy trimester at the time of CO poisoning had a significant relationship to birth weight (P = 0.029). Also, the week of pregnancy at the time of the incident correlated with the age of walking independently (P = 0.043, r = 0.436).
Conclusions: This is the largest relevant series and longest follow-up to date. Adverse outcomes were likely incidental because the mothers’ medical histories revealed alternative aetiologies. There was no definite evidence of fetal morbidity or mortality after HBOT in this study. HBOT may improve long-term fetal outcomes after in-utero CO poisoning without complications.

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.

Publication Type: Original article


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):256–263. doi: 10.28920/dhm51.3.256-263. PMID: 34547776.

Effect of hyperbaric oxygen treatment on patients with reduced left ventricular ejection fraction

Joëlle Vincent1,2, Marie-Kristelle Ross2,3,5, Neal W Pollock2,4,5

1 Department of Medicine, Université Laval, Québec, Canada
2 Service de Médecine Hyperbare, Hôtel-Dieu de Lévis, Québec, Canada
3 Department of Cardiology, Hôtel-Dieu de Lévis, Québec, Canada
4 Department of Kinesiology, Université Laval, Quebec, Canada
5 Centre de médecine de plongée du Québec, Hôtel-Dieu de Lévis, Québec, Canada

Corresponding author: Dr Joëlle Vincent, Department of medicine, Université Laval, 1050, avenue de la Médecine, Québec, QC, G1V 0A6, Canada
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Key words
Adverse effects; Cardiovascular; Heart failure; Hyperbaric medicine; Pulmonary oedema; Safety

Abstract
(Vincent J, Ross M-K, Pollock NE. Effect of hyperbaric oxygen treatment on patients with reduced left ventricular ejection fraction. Diving and Hyperbaric Medicine. 2021 September 30;51(3):256–263. doi: 10.28920/dhm51.3.256-263. PMID: 34547776.)
Introduction: Hyperbaric oxygen treatment (HBOT) is available to a wide spectrum of patients, many with significant co-morbidities. Considering its effects on cardiac physiology and reports of pulmonary oedema following exposure, concerns exist about the safety of patients with compromised cardiac function. Few studies have described adverse events occurring during HBOT and even fewer reports address events arising in the hours following HBOT. A relation between adverse events and cardiac function has not been established. As medical guidance is limited, we aimed to evaluate the risk for patients with reduced left ventricular ejection fraction (LVEF) receiving HBOT.
Methods: This retrospective chart review of patients receiving HBOT from April 2003 through December 2019 at our hospital was designed to describe clinical characteristics of patients and to identify adverse events during HBOT and within 24 hours after HBOT. Patients ≥ 40 years of age with a documented LVEF of ≤ 40% were included. Data are presented as mean (SD) [range] or counts, as appropriate.
Results: A total of 23 patients were included in the final analysis, 2 (1) [0–4] patients per year. Patients received 25 (19) [1–60] treatments. Two patients had an episode of acute decompensated heart failure possibly linked to HBOT.
Conclusions: This study described the clinical characteristics of patients with reduced LVEF receiving HBOT and showed reassuring results, with a majority of patients with reduced LVEF tolerating HBOT well. Prospective research is required to more fully assess the risk.

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.

Publication Type: Original article


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):264–270. doi: 10.28920/dhm51.3.264-270. PMID: 34547777.

Regular medication use by active scuba divers with a declared comorbid medical condition and victims of scuba and snorkelling-related fatalities

Simone E Taylor1, David McD Taylor2,3, Daisy Pisasale1, Kyle Booth4, John Lippmann5

1 Pharmacy Department, Austin Hospital, Victoria, Australia
2 Emergency Department, Austin Hospital, Victoria, Australia
3 Department of Medicine, Melbourne University, Victoria, Australia
4 Pharmacy Department, Eastern Health, Victoria, Australia
5 Australasian Diving Safety Foundation, Ashburton, Victoria, Australia

Corresponding author: Professor David McD Taylor, Emergency Department, Austin Health, PO Box 5555, Heidelberg, Victoria, Australia 3084. ORCID: 0000-0002-8986-9997.
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Key words
DAN – Divers Alert Network; Diving deaths; Diving incidents; Health status; Pharmacology; Recreational diving

Abstract
(Taylor SE, Taylor DM, Pisasale D, Booth K, Lippmann J. Regular medication use by active scuba divers with a declared comorbid medical condition and victims of scuba and snorkelling-related fatalities. Diving and Hyperbaric Medicine. 2021 September 30;51(3):264–270. doi: 10.28920/dhm51.3.264-270. PMID: 34547777.)
Introduction: The aim of this study was to describe the nature of regular medications taken by active comorbid scuba divers (having a declared medical comorbidity) and scuba divers and snorkellers who died following a diving incident.
Methods: We undertook a retrospective, observational study from July to October, 2020. Data on 268 active comorbid divers were obtained through a 2013 survey of Divers Alert Network Asia-Pacific members. Data on 126 deceased scuba divers and 175 deceased snorkellers were obtained predominantly from 2001–2013 reports to Australian State Coronial Services.
Results: The active comorbid divers were significantly older, less likely to be male, and more likely to be taking one or more medications than the two deceased subject groups (P < 0.001). Cardiovascular, endocrine and psychotropic medications accounted for 53.4%, 9.9% and 6.4% of all medications taken, respectively. Almost one tenth of the deceased divers took at least one psychotropic medication, a proportion significantly greater than the other groups (P = 0.01).
Conclusions: Medication use among active comorbid divers is common which likely reflects their declared medical condition. Nevertheless, they appear to be diving relatively safely, often with conditions once thought to be absolute contradictions to scuba diving. The deceased divers took significantly more psychotropic medications. It is possible that their underlying psychological/psychiatric conditions rendered them more at risk of a diving incident. Increased vigilance for psychological conditions may need to be considered during diving medical examinations.

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.

Publication Type: Original article


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):271–281. doi: 10.28920/dhm51.3.271-281. PMID: 34547778.

Efficacy and safety of hyperbaric oxygen treatment in SARS-COV-2 (COVID-19) pneumonia: a systematic review

Sylvain Boet1,2,3, Cole Etherington2, George Djaiani4, Andrea C Tricco5,6, Lindsey Sikora7, Rita Katznelson4

1 Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Ottawa, Canada
2 Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, Canada
3 Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, Canada
4 Department of Anesthesia and Pain Management, University Health Network, Toronto, Canada
5 Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Canada
6 Epidemiology Department and Institute for Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
7 Health Sciences Library, University of Ottawa, Ottawa, Canada

Corresponding author: Dr Sylvain Boet, Department of Anesthesiology and Pain Medicine, Hyperbaric Medicine Unit, The Ottawa Hospital, 501 Smyth Rd, Critical Care Wing 1401, Ottawa, K1H 8L6, Ontario, Canada
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Key words
Hyperbaric medicine; Hypoxia; Infection

Abstract
(Boet S, Etherington C, Djaiani G, Tricco AC, Sikora L, Katznelson R. Efficacy and safety of hyperbaric oxygen treatment in SARS-CoV-2 (COVID-19) pneumonia: a systematic review. Diving and Hyperbaric Medicine. 2021 September 30;51(3):271–281. doi: 10.28920/dhm51.3.271-281. PMID: 34547778.)
Introduction: The need for intubation and mechanical ventilation among COVID-19 patients is associated with high mortality rates and places a substantial burden on the healthcare system. There is a strong pathophysiological rationale suggesting that hyperbaric oxygen treatment (HBOT), a low-risk and non-invasive treatment, may be beneficial for COVID-19 patients. This systematic review aimed to explore the potential effectiveness and safety of HBOT for treating patients with COVID-19.
Methods: Medline, Embase, Scopus, and Google Scholar were searched from December 2019 to February 2021, without language restrictions. The grey literature was searched via an internet search engine and targeted website and database searches. Reference lists of included studies were searched. Independent reviewers assessed studies for eligibility and extracted data, with disagreements resolved by consensus or a third reviewer. Risk of bias was assessed using the Newcastle Ottawa Scale. Data were summarised descriptively.
Results: Six publications (one cohort study, five case reports/series) met the inclusion criteria with a total of 37 hypoxaemic COVID-19 patients treated with HBOT. Of these 37 patients, the need for intubation and mechanical ventilation and in-hospital survival were assessed for 26 patients across three studies. Of these 26 patients, intubation and mechanical ventilation were not required for 24, and 23 patients survived. No serious adverse events of HBOT in COVID-19 patients were reported. No randomised trials have been published.
Conclusions: Limited and weak evidence from non-randomised studies including one propensity-matched cohort study suggests HBOT is safe and may be a promising intervention to optimise treatment and outcomes in hypoxaemic COVID-19 patients. Randomised controlled studies are urgently needed.

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.

Publication Type: Original article


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):282–287. doi: 10.28920/dhm51.3.282-287. PMID: 34547779.

Injuries in underwater rugby: a retrospective cross-sectional epidemiological study

Heinz-Lothar Meyer1, Felicitas Minnemann1, Christina Polan1, Manuel Burggraf1, Marcel Dudda1, Max D Kauther1

1 Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen

Corresponding author: Dr med Heinz-Lothar Meyer, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Hufelandstraße 55, 45147 Essen, Germany. ORCID: 0000-0002-3472-4758.
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Key words
Aquatic sports; Breath-hold diving; Diving research; Epidemiology; Gender; Health Survey; Trauma

Abstract
(Meyer H-L, Minnemann F, Polan C, Burggraf M, Dudda M, Kauther MD. Injuries in underwater rugby: a retrospective cross-sectional epidemiological study. Diving and Hyperbaric Medicine. 2021 September 30;51(3):282–287. doi: 10.28920/dhm51.3.282-287. PMID: 34547779.)
Introduction: Underwater rugby (UWR) is a team sport which combines swimming sprints, apnoea diving, a good overview of the three-dimensional underwater space and wrestling for the ball.This was the first epidemiological study of UWR injuries in a large international collective.
Methods: A questionnaire containing 124 questions was distributed to 198 active UWR players and completed under the supervision of medical staff. Demographic data and information about injuries in ten different body regions were collected.
Results: Of the 198 respondents, 106 (53.5%) were male and 92 (46.5%) were female. On average, each UWR player suffered a median of 19.5 (IQR 44) injuries. Based on the exposure time, means of 37.7 (SD 90.0) injuries per 1000 playing hours per player and 9.9 (20.1) injuries per year were found. Significant injuries mainly occurred to the head region (45.7%). Bruises and sprains were observed more often than fractures and dislocations. Male athletes had a longer total injury break time (median 4.8 [IQR 10.5] days), than female athletes (4 [8.6] days). Female athletes had more injuries (median 20 [IQR 26.8]) than male athletes (18.5 [63]). The length of the injury-related break time increased with the rise in body mass index.
Conclusions: The risk of severe injury in UWR is low compared to other ball sports like water polo and rugby. UWR is played under water and the impact of tackles is lessened by the water. Further studies should record chronic injuries in UWR and establish measures to prevent injury.

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.

Publication Type: Original article


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):288–294. doi: 10.28920/dhm51.3.288-294. PMID: 34547780.

Perioperative hyperbaric oxygen treatment and postoperative complications following secondary breast reconstruction after radiotherapy: a case-control study of 45 patients

Eva L Meier1, Stefan Hummelink1, Nina Lansdorp2, Onno Boonstra2, Dietmar JO Ulrich1

1 Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
2 Da Vinci Clinic, Arnhem, The Netherlands

Corresponding author: Dr Eva Meier, Department of Plastic and Reconstructive Surgery (hp 634), Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Key words
Cancer; Hyperbaric research; Outcome; Soft tissue radionecrosis; Surgery; Women

Abstract
(Meier EL, Hummelink S, Lansdorp N, Boonstra O, Ulrich DJO. Perioperative hyperbaric oxygen treatment and postoperative complications following secondary breast reconstruction after radiotherapy: a case-control study of 45 patients. Diving and Hyperbaric Medicine. 2021 September 30;51(3):288–294. doi: 10.28920/dhm51.3.288-294. PMID: 34547780.)
Introduction: Radiotherapy reduces the risk of locoregional recurrence of breast cancer. As a side-effect, tissue can become hypocellular, hypovascular, and hypoxic and late radiation tissue injury can develop months or years later. Radiotherapy increases the risk of complications following secondary breast reconstruction. Hyperbaric oxygen treatment (HBOT) improves oxygenation of irradiated tissue and induces neovascularisation. This study evaluated whether the incidence of complications following secondary breast reconstruction after radiotherapy is decreased with perioperative HBOT.
Methods: In this retrospective case-control chart review study, patients who underwent perioperative HBOT (n = 15) were compared to lifestyle-matched (n = 15) and radiation damage-matched (n = 15) patients who underwent secondary breast reconstruction without HBOT.
Results: The HBOT group had significantly more severe radiation damage of the breast than the lifestyle- and radiation-damage-matched control groups (scoring grade 1−4, mean 3.55 versus 1.75 and 2.89 respectively, P = 0.001). Patients underwent on average 33 sessions of HBOT (18 sessions preoperatively and 15 sessions postoperatively). There was no significant difference in the incidence of postoperative complications between the HBOT group, lifestyle-matched group and radiation damage-matched group. Logistic regression analysis showed a lower risk of postoperative complications in patients who underwent HBOT.
Conclusions: Although the HBOT group had more radiation damage than the control groups, the incidence of postoperative complications was not significantly different. This implied a beneficial effect of HBOT, which was supported by the logistic regression analysis. Definitive conclusions cannot be drawn due to the small sample size. Future research is justified, preferably a large randomised controlled trial.

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.

Publication Type: Original article


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):295–298. doi: 10.28920/dhm51.3.295-298. PMID: 34547781.

Proof-of-concept for a segmented composite diving suit offering depth-independent thermal protection

Aaron Demers1, Shane Martin1, Emil P Kartalov1

1 Physics Department, Naval Postgraduate School, Monterey CA, USA

Corresponding author: Professor Emil P Kartalov, Physics Department, Naval Postgraduate School, 833 Dyer Road, Monterey, CA 93943, USA
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Key words
Buoyancy; Cold; Hypothermia; Microspheres; Wetsuit

Abstract

(Demers A, Martin S, Kartalov EP. Proof-of-concept for a segmented composite diving suit offering depth-independent thermal protection. Diving and Hyperbaric Medicine. 2021 September 30;51(3):295–298. doi: 10.28920/dhm51.3.295-298. PMID: 34547781.)
Heat loss is a major health hazard for divers. It can lead to hypothermia, organ damage, unconsciousness, and eventually death. Hence, thermal protection is essential for diver safety. Typically, protection is provided by wetsuits made of bubbled neoprene. However, neoprene shrinks with depth and loses thermal insulation capability, while thick neoprene suits make swimming exhausting. Herein, a proof-of-concept is presented for a solution to both problems: a ‘K-suit’ made of thermally-resistive composite segments attached to a thin neoprene suit. The segments are made of hollow glass microspheres embedded in carrier polymer thermally cured in 3D-printed molds based on 3D-scans of the diver’s body. The K-suit was compared in field trials with a 7 mm commercial neoprene suit by diving in pairs, while automated dataloggers registered pressure and temperature inside and outside both suits. The K-suit demonstrated +4ºC higher temperature difference than the 7 mm neoprene. Also, divers reported that the K-suit had the ergonomics of a 3 mm neoprene suit. These preliminary results represent a proof-of-concept for the K-suit and promise further improvements with potential impact on diver safety.

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.

Publication Type: Short communication


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):299–302. doi: 10.28920/dhm51.3.299-302. PMID: 34547782.

Haemoptysis in breath-hold divers; where does it come from?

Igor Barković1,2,3, Vitomir Maričić4, Boris Reinić3, Frano Marinelli1,2,3, Tamara Turk Wensveen5

1 Center for Research and Education in Underwater, Hyperbaric and Maritime Medicine, University of Rijeka, Faculty of Medicine, Rijeka, Croatia
2 Department of Pulmonology, Clinic for Internal Medicine, Clinical Hospital Center Rijeka, Rijeka, Croatia
3 Department for Underwater and Hyperbaric medicine, Clinical Medical Center Rijeka, Rijeka, Croatia
4 AIDA - International Association for the Development of Apnea, Croatia
5 Specialized Hospital for Medical Rehabilitation of Cardiac, Pulmonary and Rheumatic Diseases, Thalassotherapia Opatija, Opatija, Croatia

Corresponding author: Associate Professor Dr. Sc. Igor Barković, dr. med. Tome Strižića 3, 51000 Rijeka, Croatia
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Key words
Bronchoscopy; Case reports; Freediving; Hemoptysis; Pulmonary barotrauma; Pulmonary oedema

Abstract

(Barković I, Maričić V, Reinić B, Marinelli F, Wensveen TT. Haemoptysis in breath-hold divers; where does it come from? Diving and Hyperbaric Medicine. 2021 September 30;51(3):299–302. doi: 10.28920/dhm51.3.299-302. PMID: 34547782.)
Introduction: The aim of reporting these two cases is to present visual evidence by bronchoscopy of the origin of haemoptysis in two elite breath-hold divers.
Case reports: Two male elite breath-hold divers of similar physical characteristics presented to our clinic after performing dives of up to 75 and 59 meters of seawater depth for 2:30 and 2:35 (minutes:seconds) respectively. Both patients presented with haemoptysis. Lung ultrasound was performed. The first patient had crackles on chest auscultation, overt pulmonary oedema clinically and 90 ultrasound lung comets. The second patient had no oedema or crackles, but presented with 20 ultrasound lung comets. Video bronchoscopy was performed which showed traces of blood coming from all three segments of the right upper lobe in both patients. The rest of the airways and lungs were intact.
Conclusions: These finding suggest that the apical parts of the lungs are the most prone to deep-dive induced damage. The precise mechanism of lung barotrauma and haemoptysis in breath-hold divers remains to be elucidated. These findings may be of importance for a better understanding of the underlying pathology of haemoptysis.

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.

Publication Type: Case report


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):303–305. doi: 10.28920/dhm51.3.303-305. PMID: 34547783.

Air embolism during lumbar surgery in the prone position

Lionel Bapteste1, Zeinab Kamar1, Anthony Mazaud2, Baptiste Balança1

1 Anesthésie Réanimation Hospices Civils de Lyon, France
2 Centre de médecine hyperbare Hospices Civils de Lyon, France

Corresponding author: Dr Lionel Bapteste, Anesthésie Réanimation Hospices Civils de Lyon, France
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Key words
Anaesthesia; Case reports; Cerebral arterial gas embolism (CAGE); Hyperbaric oxygen treatment; Neurosurgery; Surgery

Abstract

(Bapteste L, Kamar Z, Mazaud A, Balança B. Air embolism during lumbar surgery in the prone position. Diving and Hyperbaric Medicine. 2021 September 30;51(3):303–305. doi: 10.28920/dhm51.3.303-305. PMID: 34547783.)
Only a few clinical cases of cerebral arterial gas embolism during spinal surgery are published. It seems important not to overlook this diagnosis in order to initiate rapid appropriate treatment. This was a suspected case of paradoxical gas embolism revealed postoperatively by neurological deficits and whose recovery was noted during hyperbaric oxygen treatment. Unfortunately, no complementary examination showed gas embolism and only the context, the clinical picture and the case evolution evoke this diagnosis. The diagnostic difficulty in the immediate postoperative period is highlighted.

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.

Publication Type: Case report


2021 September;51(3)

Diving Hyperb Med. 2021 September 30;51(3):306-307. doi: 10.28920/dhm51.3.306-307. PMID: 34547784.

Anxiety impact on scuba performance

Michael Davis1, John Leach2

1 Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
2 Extreme Environments Research Group, University of Portsmouth, Portsmouth, United Kingdom

Address for correspondence: Michael Davis, Department of Anaesthesiology, University of Auckland, Auckland, New Zealand
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Key words
Letters (to the Editor); Performance; Personality; Psychology; Recreational diving; Stress; Women

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.

Publication Type: Letter to the Editor

Diving and Hyperbaric Medicine is indexed on MEDLINE, Science Citation Index Expanded (SciSearch®) and Embase/Scopus and complies with the International Committee of Medical Journal Editors (ICMJE) Recommendation for the Conduct, Report, Editing and Publication of Scholarly Work in Medical Journals.
Articles from 2017 are deposited in PubMed Central