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Number 6

Emphysematous cystitis successfully treated with hyperbaric oxygen therapy: case report

Emphysematous cystitis is an uncommon acute infection of the underlying bladder musculature and mucosa, caused by gas-producing organisms. Here we describe an 87-year-old woman with diabetes mellitus and emphysematous cystitis who was successfully treated with hyperbaric oxygen (HBO2) therapy. Her predisposition of diabetes and infection with gas-producing bacteria was considered to precede the development of emphysematous cystitis. Computed tomography revealed gas accumulation in the bladder wall and lumen. Antibiotics and HBO2therapy were administered. HBO2 therapy may be beneficial due to the improvement in oxygenation of the tissues affected by the disease. HBO2 is a useful adjunct therapy for the management of severe emphysematous cystitis. DOI: 10.22462/11.12.2018.13

  01-09-2019

Hyperbaric oxygen therapy as adjuvant therapy in necrotizing fasciitis of the face: case report

Facial necrotizing fasciitis is a rare bacterial infectious disease. Rapid necrosis of the tissues and suppurative fasciitis is pathognomonic. It can be seen following odontogenic infection. Early aggressive debridements and wide-spectrum antibiotic therapy are currently accepted treatments. A 60-year-old man was admitted to the otolaryngology clinic for facial pain and swelling after odontogenic infection. Inflamed left maxilla and orbit were seen, and abscess contents spontaneously drained into the mouth. It was determined that infectious markers were increased inthe blood. On MRI, a broad abscess with edema and gas formation were seen. Debridement of the necrotic tissue was performed immediately and ..

  01-09-2019

Compartment syndrome in the forearm related to carbon monoxide intoxication: case report

Introduction: Carbon monoxide (CO) poisoning is one of the most common forms of intoxication around the world. One of the complications associated with CO exposure is direct toxicity to the skeletal muscles. Though compartment syndrome induced by CO intoxication is rare, it is a well-known complication. In this study, we present a case of CO poisoning in a patient who developed compartment syndrome in his forearm. Case report: A 22-year-old man was found unconscious in a motel where a briquette had burned. He was later diagnosed with rhabdomyolysis associated with CO poison- ing. After he regained consciousness, he experienced difficulty in moving his left arm, ..

  01-09-2019

Hyperbaric oxygen therapy for cerebral air gas embolism following orthotopic heart transplant: case report

Air gas embolism (AGE) is a rare complication of cardiac surgery with high morbidity and mortality. We present a case of suspected AGE following orthotopic heart transplant. The patient received hyperbaric oxygen therapy with near complete resolution of symptoms at follow-up. This case exemplifies the difficulty in diagnosis of AGE, the considerations involved in the treatment of a critical care patient in a hyperbaric chamber, and utility in treating a patient for AGE even after a delay in diagnosis. DOI: 10.22462/11.12.2018.10

  01-09-2019

Risk of continuous bladder irrigation in the monoplace hyperbaric chamber: a cautionary tale

We previously published our method of performing continuous bladder irrigation (CBI) in a monoplace hyperbaric chamber [1]. This method entailed the use of an IV pump to infuse saline into the monoplace chamber. The specter of causing iatrogenic rupture of the bladder was raised following such a case, reported herein, of a woman with hemorrhagic radiation cystitis leading to cystectomy. Due to the danger of bladder rupture while providing CBI with a pump, we retract our previously reported method and encourage the use of either a gravity-fed system or delay in hyperbaric oxygen therapy treatment until CBI is no longer necessary. DOI: 10.22462/11.12.2018.9

  01-09-2019

Underwater nasal decongestant use: a novel approach to middle ear equalization

Middle ear barotrauma is the most common diving-related injury. It is estimated to occur in more than 50% of ex- perienced divers. Although divers learn how to effectively equalize their ears with various maneuvers, airway congestion may impede the ability to equalize the middle ear space via the Eustachian tube. In this case, one may have to avoid diving or abort a dive due to inability to descend. If difficulty with middle ear equalization occurs during the bottom phase of the dive, which may transpire during a multilevel cave or wreck dive, a diver may need to descend before he ..

  01-09-2019

Hyperbaric oxygen therapy decreases QTc dispersion that increased in CO poisoning

Myocardial injury is a frequent consequence of moderate to severe CO (carbon monoxide) poisoning and a significant predictor of mortality in CO injury. Electrocardiography (ECG) is an easily accessible diagnostic tool for evaluating myocardial damage. Increased QT interval and QT dispersion are related to heterogeneity of regional ventricular repolarization and can develop into arrhythmias. It has been reported that QT interval and QT dispersion increase in patients with CO poisoning. Hyperbaric oxygen (HBO2) therapy has been used successfully in treating patients with CO poisoning. The aim of this study was to investigate change of corrected QT (QTc) interval and QTc ..

  01-09-2019

The use of indocyanine green fluorescence angiography to assess perfusion of chronic wounds undergoing hyperbaric oxygen therapy

Objective: The purpose of this study is to determine the utility of using indocyanine green fluorescence angiography (IGFA) in assessing perfusion of chronic wounds after hyperbaric oxygen (HBO2) therapy. Method: From May 2016 to January 2018, 26 patients underwent both HBO2 and IGFA. A near-infrared charge- coupled camera measured the flow of intravenous indo- cyanine green into the wound. IGFA was done pre-HBO2, after approximately 10 HBO2 sessions, and upon completion of HBO2. The ingress rate at baseline, mid-therapy and post-HBO2 values were compared using descriptive statistics. Results: A total of 26 chronic wounds were identified. Baseline median ingress rate was 0.90 units/second (IQR: 0.28 to ..

  01-09-2019

The influence of hyperbaric environment on the skeletal muscle mitochondrial energetic of rats after induced muscle contusion

Objective: Analyze the influence of the hyperbaric environment on skeletal muscle mitochondrial bioenergetic end-points of rats submitted to muscle contusion. Methods: Twelve female Wistar rats were randomly assigned to three groups. All rats were submitted to muscle contusion in the right gastrocnemius through a standard protocol. The control group (C) remained under normo- baric conditions without any treatment. The hyperbaric air (HB) and the hyperbaric oxygen (HBO2) groups had four sessions of HBO2 therapy 60 minutes, six, 12, 24 and48 hours after the injury at 253.25 kPa (2.5 atmospheres absolute/ATA) with air or 100% oxygen, respectively. The animals were sacrificed 48 hours after ..

  01-09-2019

The relationship between intoxication severity and blood interleukin 6, interleukin 10 and CRP levels in carbon monoxide-poisoned patients

Carbon monoxide (CO) is one of the most common causes of death due to intoxications. No biochemical marker is available to evaluate the severity of CO intoxication. We measured high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and interleukin-10 (IL-10) levels in patients with different degrees of CO poisoning. We prospectively included 40 CO-poisoned patients admitted to emergency services. Blood samples were collected from the patients at admission (0 hour) and after treatment (six hours). While all patients received normobaric oxygen (NBO2) therapy, patients with severe CO poisoning received additional sessions of hyperbaric oxygen (HBO2) therapy. Blood samples were also collected from ..

  01-09-2019

Effect of mild hyperbaric oxygen therapy on children diagnosed with autism

Introduction: Hyperbaric oxygen (HBO2) therapy is emerging internationally as the primary treatment modality for inflammatory pathways related to neurological disorders. Currently, literature concerning its effectiveness in autistic children is limited. Using neurocognitive tests and clinical-diagnostic evaluations, this study evaluates the clinical, cognitive and behavioral effects of HBO2 on children diagnosed with autism. Methods: An experimental HBO2 group (EXP: F = 1; M = 7; mean age: 7 ± 2.33; years) and a control non-HBO2 group of autistic children (CTRL: F = 2; M= 5; mean age: 6.6 ± 2.7 years) correctly completed the Aberrant Behavior Checklist-Community (ABC) before HBO2 (T0), after 40 sessions of HBO2 (T1), and one ..

  01-09-2019

Evaluation of fatal diving accidents in Turkey

In any kind of diving there is a risk of accidents, as the move from the topside environment to underwater can affect a diver’s physiological and psychological condition. It is important to investigate dive accidents to clarify the causative factors and determine preventive measures.  In this study, autopsy files of fatal dive accident cases were reviewed to evaluate demographic data, type of diving, purpose of dive, seasonal distribution, autopsy findings, and causes of death. We reviewed 56 fatal dive accident files from autopsy units in cities where dive activities are concentrated and from the archive of the Turkish Underwater Federation. Four cases were excluded from the study since we were unable ..

  01-09-2019

Understanding dive behavior of artisanal fishermen divers of the Yucatán Peninsula

Introduction/Background: Artisanal fishermen dive for sustenance. The lifetime prevalence of decompression sickness (DCS) in this population is alarmingly high. We wanted to understand the level of decompression stress fishermen in this region of the Yucatán experience in their daily fishing effort. We used a mathematical model to quantify nitrogen-loading in a nine-tissue compartment model. Materials and methods: Approved by the UCLA IRB 2#13-000532, this study was conducted during fishing seasons 2012 through 2017. Diving fishermen were instructed to attach dive recorders to their waists every fishing day during the study period. Sensus Ultra dive recorders (ReefNet Inc.), with an accuracy ..

  01-09-2019