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Number 3

Hypercapnia in diving: a review of CO2 retention in submersed exercise at depth

Carbon dioxide (CO2) retention, or hypercapnia, is a known risk of diving that can cause mental and physical impairments leading to life-threatening accidents. Often, such accidents occur due to elevated inspired carbon dioxide. For instance, in cases of CO2 elimination system failures during rebreather dives, elevated inspired partial pressure of carbon dioxide (PCO2) can rapidly lead to dangerous levels of hypercapnia. Elevations in PaCO2 (arterial pressure of CO2) can also occur in divers without a change in inspired PCO2. In such cases, hypercapnia occurs due to alveolar hypoventilation. Several factors of the dive environment contribute to this effect through ..

  05-25-2017

Observed decompression sickness and venous bubbles following 18-msw dive profiles using RN Table 11

The venous bubble load in the body after diving may be used to infer risk of decompression sickness (DCS). Retrospective analysis of post-dive bubbling and DCS was made on seven studies. Each of these investigated interventions, using an 18 meters of sea water (msw) air dive profile from Royal Navy Table 11 (Mod Air Table), equivalent to the Norwegian Air tables.  A recent neurological DCS case suggested this table was not safe as thought. Two-hundred and twenty (220) man-dives were completed on this profile. Bubble measurements were made following 219 man-dives, using Doppler or 2D ultrasound measurements made on the ..

  05-25-2017

Hyperbaric oxygen therapy may overcome nitric oxide blockage during cyanide intoxication

Purpose: To determine the effects of a blockade of nitric oxide (NO) synthesis on hyperbaric oxygen (HBO2) therapy during cyanide (CN) intoxication. Methods: 39 anesthetized female Sprague-Dawley rats were exposed to CN intoxication (5.4 mg/kg intra-arterially) with or without previous nitric oxide synthase (NOS) inhibition by L-NG-nitroarginine methyl ester (L-NAME) injection (40 mg/kg intraperitoneally). Subsequently, either HBO2 therapy (284 kPa/90 minutes), normobaric oxygen therapy (100% oxygen/90 minutes) or nothing was administered. Intracerebral microdialysis was used to measure the interstitial brain concentration of lactate, glucose, glycerol and lactate/pyruvate ratios.  Results: L-NAME potentiated CN intoxication by higher maximum and prolonged lactate (in mM: 0. 5+/- 0.3 vs. ..

  05-25-2017

Effects of hyperbaric oxygen therapy on open tibial fractures in rabbits after transient seawater immersion

Objective: To explore the effect and mechanism of hyperbaric oxygen (HBO2) therapy of open tibial fractures in rabbits after transient seawater immersion. Methods: Forty-eight (48) New Zealand rabbits were randomly and averagely divided into an HBO2 therapy group (Group A) and a control group (Group B). All rabbits were subjected to unilateral open tibial fractures, while immersed in artificial seawater (20-22 °C) for three hours prior to debridement and external fixation. Group A was treated with HBO2 at 2 atmospheres absolute (ATA) for 50 minutes once daily for two weeks; Group B received postoperative routine treatments only. The fracture zone in each ..

  05-25-2017

A ZigBee-based wireless system for monitoring vital signs in hyperbaric chambers: Technical report

This paper presents the replacement of a traditional wired communication link of the hyperbaric chambers with a wireless ZigBee-based system. This move allows a reduction in the costs of seals capable of withstanding the internal pressures and gives rise to a more versatile system. The new system is able to capture and process individual vital signs like the electrocardiography signal, and other analog sources, sending the data to an external computer and allowing analysis, representation and sharing with medical staff. This system solves such problems as the attenuation of the signal produced by the metal walls of the hyperbaric chamber and has ..

  05-25-2017

Increased circulating stem cells and better cognitive performance in traumatic brain injury subjects following hyperbaric oxygen therapy

Traumatic brain injury (TBI) may cause persistent cognitive dysfunction. A pilot clinical study was performed to determine if hyperbaric oxygen (HBO2) treatment improves cognitive performance. It was hypothesized that stem cells, mobilized by HBO2 treatment, are recruited to repair damaged neuronal tissue. This hypothesis was tested by measuring the relative abundance of stem cells in peripheral blood  and cognitive performance during this clinical trial. The subject population consisted of 28 subjects with persistent cognitive impairment caused by mild to moderate TBI suffered during military deployment to Iraq or Afghanistan. Fluorescence-activated cell sorting (FACS) analysis was performed for stem cell markers in peripheral blood and correlated ..

  05-25-2017

Use of indocyanine green fluorescent angiography in a hyperbaric patient with soft tissue radiation necrosis: a case report

Introduction: Indocyanine green fluorescent angiography (ICFA), commonly used to assess vascularity in patients with non-healing lower extremity wounds, is emerging as a useful adjunct for hyperbaric oxygen (HBO2) therapy patients. We describe the use of ICFA to measure vascularity and help tailor an appropriate HBO2 regimen in a patient with breast soft tissue radiation necrosis (STRN). Case report: A 67-year-old female with a history of right breast cancer treated two years previously with lumpectomy and radiation therapy (6200 cGy), developed open wounds in the right breast. A diagnosis of STRN was established; the patient completed 20 HBO2 treatments, followed by surgical ..

  05-25-2017

Fatal cardiopulmonary decompression sickness in an untrained fisherman diver in Yucatán, Mexico: a clinical case report

Introduction: In Yucatán, Mexico, during the sea cucumber season fishermen dive intensely to obtain good catches but are often at risk of decompression sickness (DCS). We present a single case fatality.  Objective: We analyzed the clinical course, medical assessment and recompression treatment plan of an untrained fisherman.  Case report: A 35-year-old male ascended rapidly using compressed-air diving. Before reaching the coast, he reported dizziness, shortness of breath, and pain in the abdomen and legs. Three hours later, when symptoms worsened, he went to the hospital. He was admitted with increased osteotendinous reflexes and cutis marmorata in the abdomen. The patient was diagnosed with carbon monoxide ..

  05-25-2017

Is decompression illness possible during hyperbaric therapy? A case report

A 57-year-old woman was admitted to the intensive care unit in a state of severe hypotensive shock following a session of hyperbaric oxygen (HBO2) therapy. Shock was attributed to gastric barotrauma, which resulted in a massive venous gas embolism. Gastric barotrauma was attributed to the presence of a filled gastric band/cuff during the HBO2 therapy that prevented expanding gas from escaping on decompression.  After deflation of the gastric band, two additional HBO2 sessions were performed and resulted in complete symptom resolution. Vasoactive drugs could be weaned, and the patient was discharged from hospital on Day Three with complete symptom resolution. Given ..

  05-25-2017

Swimming-induced pulmonary edema in a tropical climate: a case report

Purpose: Pulmonary edema following hyperbaric oxygen (HBO2) therapy is a rare clinical phenomenon. This case report describes such a patient – a 56-year-old woman who suffered from severe pulmonary edema after HBO2 therapy for carbon monoxide (CO) poisoning.  Case: Patient experienced ecphysesis and dyspnea suddenly after HBO2 therapy (100% oxygen at 0.25 MPa, for 60 minutes with a five-minute air break and decompression at 0.01 MPa/minute). Post therapy her heart rate (HR), blood pressure (BP), respiratory rate (RR) and oxygen saturation (SO2) were 140 bpm, 60/40 mmHg,  38 bpm and 84%, respectively. Diagnoses of acute pulmonary edema and shock were made.  Various treatments including ..

  05-25-2017