Introduction: In Part 1 of this three-part series, we provided an explanation as to why and at what sites decompression sickness (DCS) occurs, using the Gradient-Perfusion Model (GPM). In this part, we provide information to substantiate the concept and present clinical cases that were initially labeled as “unexplained DCS,” but later disordering events were identified to explain the clinical presentations. Materials and Methods: Among 500 cases of DCS we have managed for over 50 years, a cohort of these patients was initially diagnosed as unexplained DCS. However, some have shown that disordering events are the likely cause of their DCS. Results: ..

08-06-2018

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 ..

08-06-2018

Risk perception in small-scale fishers and hyperbaric personnel: A risk assessment of hookah diving

Hookah diving is a fishing method used in many small-scale fisheries in the Gulf of Mexico and the Caribbean Sea, as well as in many coastal fisheries around the world. Many high-value species like sea cucumber and spiny lobster, among others, are harvested via hookah diving. However, the fishing method presents a risk for both decompression illness and carbon monoxide poisoning, both causes of disabilities and death among small-scale fishers, and with significant negative impacts on the social and economic status of households and coastal communities. Currently, there is a misunderstanding among fishers concerning diving risks. Using a mixed-method ..

08-06-2018

Protective effects of hyperbaric oxygen preconditioning against LPS-induced acute lung injury in rats

Introduction: Acute lung injury (ALI) is generally caused by oxidative damages and pulmonary overinflammations. Hyperbaric oxygen preconditioning (HBO2-PC) has been proven protective against oxidative-stress-related injuries. In this study, we investigated the effect of HBO2-PC on lipopolysaccharide (LPS)-induced ALI in rats. Methods: Thirty-two Sprague-Dawley rats randomly assigned into Sham, HBO2-PC, ALI and HBO2-PC+ALI groups (eight in each group) were sacrificed at 12 hours after the injection of LPS. The severity of ALI in rats was assessed in terms of histopathological changes in addition to wet/dry weight ratios. The levels of tumor necrosis factor-? (TNF-?), interleukin (IL)-6 and IL-1β in serum and ..

08-06-2018

Neuronal nitric oxide inhibition attenuates the protective effect of HBO2 during cyanide poisoning

Purpose: Experiments have shown that hyperbaric oxygen (HBO2) therapy reduces cyanide-induced cerebral distress. The exact mechanism behind HBO2’s neuroprotective effect is unknown, but has been proposed to be mediated by an increased neuronal nitric oxide (NO) bioavailability, which may compete with cyanide for the active site of cytochrome oxidase in the mitochondrial respiratory chain. We hypothesized that the ameliorating effect of HBO2 is caused by an increased bioavailability of NO, which can be attenuated by injection of the selective neuronal NO synthase inhibitor, 7-nitroindazole, preceding the HBO2 procedure. Methods: A total of 41 anesthetized female Sprague-Dawley rats were allocated to ..

08-06-2018

PDTC ameliorates decompression induced-lung injury caused by unsafe fast buoyancy ascent escape via inhibition of NF-κB pathway

Nuclear factor kappa B (NF-κB) is the critical transcriptional factor in the pathogenesis of acute lung injury (ALI). NF-κB regulates the expression changes of inflammatory factors such as tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β) and interleukin 6 (IL-6). In a previous study we showed that decompression sickness (DCS) caused by simulated unsafe fast buoyancy ascent escape (FBAE) could result in ALI, which was characterized by expression changes of inflammatory factors in rat lung tissue. The purpose of the present work was to study the roles of NF-κB and TNF-α in the process of DCS-induced rat lung injury caused by ..

08-06-2018

Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic

We evaluated the efficacy of hyperbaric oxygen (HBO2) therapy used as a supplement to the first-line medical treatment of sudden sensorineural hearing loss (SSNHL). We tested 68 patients suffering from SSNHL within seven days of hearing loss: 21 patients received the standard treatment protocol of our department (control group) and 47 individuals were treated with an additional application of HBO2 therapy. Treatment success was assessed using pre- and post-treatment audiograms. Outcomes of our study showed a statistically significant improvement in auditory threshold in all frequency groups for the HBO2 group (P < 0.001), whereas in the control group the statistically ..

08-06-2018

Stability of residual hearing and cochlear implant function following multiple scuba dives: case report

Objectives: There are limited data regarding the safety of cochlear implants during exposure to pressure changes associated with scuba and hyperbaric oxygen therapy. There are no data regarding the effects of barometric pressure changes on preserved low-frequency hearing after cochlear implantation. This case report evaluates the effect of barometric pressure changes on preserved low-frequency hearing after cochlear implantation. Patient: This is a case report of a patient who underwent successful cochlear implantation with postoperative preservation of residual low-frequency hearing. Interventions: 20 scuba dives up to depths of 92 feet (3.8 atmospheres absolute).Main outcome measures: Preservation of hearing and maintained integrity of ..

08-06-2018

Hyperbaric Oxygen Therapy Indications (14th Ed)

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Number 3

Hyperbaric oxygen, oxidative stress and comets – An editorial perspective

Dose-time dependency of hyperbaric hyperoxia-induced DNA strand breaks in human immune cells visualized with the comet assay

Advances in the therapy of hyperoxia-induced lung injury: findings from animal models

The effect of hyperbaric conditions on olfactory functions

Use of hyperbaric oxygen on flaps and grafts in China: Analysis of studies in the past 20 years

Decompression sickness cases treated with recompression therapy between 1963 and 1998 in Turkey: Review of 179 cases

Sickle cell trait and diving: Review and recommendations

A study on dysbaric osteonecrosis in caisson workers

Performance of the Hospira Plum A+ (HB) hyperbaric infusion pump

Hyperbaric Indications Paper: Mechanisms of action of hyperbaric oxygen therapy

Hyperbaric Indications Paper: Side effects of hyperbaric oxygen therapy

Hyperbaric Indications Paper: Hyperbaric oxygen pretreatment and preconditioning

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The Gradient Perfusion Model Part 2: Substantiation of the GPM with clinical cases

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

Risk perception in small-scale fishers and hyperbaric personnel: A risk assessment of hookah diving

Protective effects of hyperbaric oxygen preconditioning against LPS-induced acute lung injury in rats

Neuronal nitric oxide inhibition attenuates the protective effect of HBO2 during cyanide poisoning

PDTC ameliorates decompression induced-lung injury caused by unsafe fast buoyancy ascent escape via inhibition of NF-κB pathway

Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic

Stability of residual hearing and cochlear implant function following multiple scuba dives: case report

Call for a multicenter study on the intra-subject variability of venous gas emboli

Excessive mechanism research about HBO2 on peripheral neuropathic pain

UHMS Position Statement: Topical Oxygen for Chronic Wounds