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Cerebral arterial gas embolism in a patient with hypoplastic left heart syndrome treated with emergent hyperbaric oxygen: case report

A 30-year-old female with a history of seizure disorder and hypoplastic left heart syndrome treated with a Norwood procedure in 1986 followed by a modified non-fenestrated Fontan (Left SVC to IVC to pulmonary arteries) with a known baffle leak presented to the emergency department. On day of presentation, the patient became unresponsive, with perioral cyanosis, rightward gaze and a left facial droop near the end of a platelet transfusion. An emergent non-contrast head CT revealed intracranial air in the right MCA distribution. She was taken to the hyperbaric chamber and was treated with a U.S. Navy Table 6 in ..


Reduction of peak expiratory flow after a 5-meter dive with extreme exertion

The effects of physically exerting scuba dives on the airways are expected to affect the respiratory system and therefore the spirometric flow indices directly after surfacing. After on-air open-sea dives, the flow indices were examined with standard spirometry (maximal forced expiration) within 10 minutes pre- and post-dive. Twenty volunteers, age 49±14 years (m±SD) equipped with a dive computer to record the dive profile, cylinder pressures and water temperature (27°C), as well as a hear rate monitor, performed 5-meter dives of 27 minutes at maximal swimming velocity (v). Mean pulmonary ventilation (PV) was 48±10 ambient L/minute (aL.min-1). Mean v was ..


ARTERIAL INSUFFICIENCIES Hyperbaric Oxygen Therapy for Selected Problem Wounds

There are sound fundamental reasons why additional oxygen may have benefits in the treatment of non-DFU wounds. It is easy to extrapolate that where there is a minimum level of tissue oxygenation required for wound healing, more oxygen in the form of HBO2 would improve healing even further. The challenge is determining whether there is evidence to support this extrapolation. Every wound that takes longer than expected to heal is a problem wound for that patient, so what makes HBO2 acceptable for the treatment of some wounds and not for others?   DOI number: To come There are sound fundamental reasons why ..


Carbon monoxide poisoning while scuba diving: a rare event?

Contamination of breathing gas is a risk for all divers. Some hydrocarbon contaminants will be sensed by the diver and the dive profile aborted. On the contrary, carbon monoxide may not be recognized by the diver and catastrophic consequences can result. Reported here is the fatal case of carbon monoxide poisoning while scuba diving, an event that has rarely been reported in the medical literature. A detailed review of other published cases of CO poisoning while scuba diving is included, attempting to identify causes in common and propose methods of prevention. DOI Number: 10.22462/03.07.2020.10


Patterns of cardiac dysfunction after carbon monoxide poisoning

Objective: To describe the structural sequelae of carbon monoxide (CO) poisoning on the heart assessed using stress cardiac MRI (CMR). CO poisoning is common. While acute cardiac injury is frequent among survivors, the mid- and long-term effects of CO on the myocardium are unclear. Methods: CMR studies performed between the years 2005 and 2014 for a primary diagnosis of CO poisoning at a tertiary care center were reviewed by an experienced cardiologist. Variables of interest were compared between patients with normal and abnormal studies to identify factors associated with cardiac dysfunction. Results: Eighty-eight patients underwent stress CMR, age 34 years (range ..


Pulmonary barotrauma during hookah diving: a case report

When commercial sea harvesters have dive accidents, it is sometimes difficult to obtain an accurate dive history and make a definitive diagnosis. We report a sea harvest diver who dived to collect sea snails (Rapana venosa) by using a hookah dive system. He experienced mediastinal and subcutaneous emphysema due to interruption of breathing airflow. Thoracic computed tomography performed one year prior to the accident revealed paramediastinal subpleural blebs on both lung apices. Emphysema was resolved by administering normobaric oxygen. DOI number: 10.22462/03.07.2020.8


Balloon Eustachian tuboplasty in a professional Navy SEAL diver: case report

Middle ear barotrauma due to dilatory Eustachian tube dysfunction (ETD) is probably the most common medical disorder related to diving. Moreover, ETD makes divers prone to other diving-related accidents, including inner ear barotrauma and alternobaric vertigo. Until the development of Eustachian tube balloon dilation no diving-compatible surgical options existed to effectively and safely prevent recurrence. We present a case of an Israeli Navy SEAL diver who dives in extreme strenuous combat-related closed-circuit rebreather (CCR) dives. Due to repeated middle ear barotrauma, the patient underwent Eustachian tube balloon dilation of the affected side. Following surgery, the patient returned to both ..


Successful adjunctive treatment of compartment syndrome due to acute isocyanate inhalation using hyperbaric oxygen therapy: case report

Introduction: Isocyanates are the raw materials that make up all polyurethane products. Isocyanate is a powerful irritant to the mucosal membrane of the respiratory tract, eyes and skin. Pulmonary symptoms, especially occupational asthma, are predominant manifestations of isocyanate toxicity. Case report: We report mental changes and compartment syndrome complicated with rhabdomyolysis as an extraordinary manifestation of acute isocyanate toxicity observed in a patient during the waterproofing of a water tank. A 58- year-old man recovered consciousness after six hours in the emergency department and complained of severe pain in the lower leg. The results of his laboratory test showed that ..


Simulation stress model of the undersea environment activates the central nervous, neuroendocrine and immune systems and anxiety in rats

The present study was designed to assess the stress responses to a simulation model of the undersea environment that is similar to some undersea working conditions such as submarine rescue, underwater salvage and underwater construction. Restraint, hyperbaric air and immersion were chosen to produce the simulation stress model in rats for four hours. Rats were randomized into five groups: control group, restraint (R) group, hyperbaric air (H) group, restraint plus hyperbaric air (RH) group, and restraint plus hyperbaric air plus immersion (RHI) group. The results showed that the responses to the simulation stress model of the undersea environment induced ..


Diffusion tensor imaging in the evaluation of the long-term efficacy of HBO2 therapy in rats after traumatic spinal cord injury

Objective: This study explored the feasibility of diffusion tensor imaging (DTI) in the evaluation of the long-term efficacy of hyperbaric oxygen (HBO2) therapy in rats after traumatic spinal cord injury (TSCI) with different degrees of injury. Method: Adult Sprague-Dawley rats (total n = 60) were randomly separated into three groups of mild, moderate and severe TSCI (20 rats per group). Each group was then randomly divided into TSCI and TSCI+HBO2 subgroups (10 rats per subgroup). Basso Beattie and Bresnahan (BBB) scores and DTI parameters including fractional anisotropy (FA), mean apparent diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were ..


Long-term effects of hyperbaric oxygen therapy on visual acuity and retinopathy

Hyperbaric oxygen (HBO2) therapy is an adjunct treatment for diabetic foot ulcers. Since plausible mechanisms of action for this treatment include increased angiogenesis and high tissue oxygen concentrations, concerns about deterioration of retinopathy have been raised. The aim of this study was to evaluate the effects of HBO2 on visual acuity (VA) and retinopathy in patients with chronic diabetic foot ulcers during a two-year follow-up period. This is a randomized, single-center, double-blinded and placebo-controlled clinical trial evaluating the effects of HBO2 in patients with diabetes mellitus and chronic foot ulcers. All study participants underwent an ophthalmological examination before the ..


Clinical efficacy of adjuvant therapy with hyperbaric oxygen in diabetic nephropathy

Background and objective: Diabetic kidney disease (DKD) is the most common microvascular chronic complication of diabetes mellitus. Hyperbaric oxygen (HBO2) therapy will increase the partial pressure of oxygen (PaO2) and may improve cell repair processes, which can lead to better renal function. The objective of this study was to quantify the efficacy of adjuvant HBO2 to increase the glomerular filtration rate and urinary albumin excretion in diabetic patients, as well as determine its effectiveness to modify the clinical course of DKD. Materials and methods: An experimental study was performed on patients with stage 3 and 4 DKD. Twenty sessions of ..


Hyperbaric oxygen therapy for COVID-19 patients with respiratory distress: treated cases versus propensity-matched controls

Objective: Given the high mortality and prolonged duration of mechanical ventilation of COVID-19 patients, we evaluated the safety and efficacy of hyperbaric oxygen for COVID-19 patients with respiratory distress. Methods: This is a single-center clinical trial of COVID-19 patients at NYU Winthrop Hospital from March 31 to April 28, 2020. Patients in this trial received hyperbaric oxygen therapy at 2.0 atmospheres of pressure in monoplace hyperbaric chambers for 90 minutes daily for a maximum of five total treatments. Controls were identified using propensity score matching among COVID-19 patients admitted during the same time period. Using competing-risks survival regression, we analyzed ..


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