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The Gradient Perfusion Model Part 3: An extraordinary case of decompression sickness

Introduction: Decompression sickness (DCS) has been associated with unusual circumstances such as breath-hold diving, shallow depths, and short bottom times. We report a case of DCS with an extraordinary cause and course.

Materials and Methods: A 72-year-old healthy Hispanic female was referred to our 24/7 Hyperbaric Medicine Unit for emergency hyperbaric oxygen recompression treatment (HBO2 RCT) after developing lower-extremity paralysis following a hyperbaric air exposure in a homemade hyperbaric chamber.

Findings/Case report: After an uneventful exposure to hyperbaric air at a maximum 72-foot depth (3.2 ATA, 32.3 psig), the patient had the delayed onset of abdominal pain and paraplegia after eating a meal. After HBO2 RCT in accordance with our management algorithm, the patient had a full recovery.

Conclusions: This patient’s presentation and course corresponded to what we label as “disordered decompression” and conformed to our Gradient Perfusion Model. With a finite blood volume and the need to perfuse two “intermediate” tissues simultaneously, we postulate that a “steal” syndrome arose to cause the abdominal and paralysis symptoms.

DOI: 10.22462/05.06.2018.6