Decompression Sickness and Arterial Gas Embolism

Mitchell, Simon J; Bennett, Michael H; Moon, Richard E.

doi:10.1056/nejmra2116554

Cited by 73 publications

(72 citation statements)

References 42 publications

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“…In this study, according to the participants’ response patterns to the DCS symptoms, three latent class types of the symptoms were identified. Examining previous studies related to DCS symptom types, Golding and his colleagues [ 35 ] classified DCS into type 1 DCS and type 2 DCS according to clinical manifestations, and Vann [ 4 ] also reported the classification into type 1 and type 2 DCS. In most cases, DCS is classified into type 1 and type 2 only in clinical practice, and, when both types are present, it is classified as type 2 DCS with high severity [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Divers absorb inert gas (nitrogen when air breathing) into tissues when breathing compressed gas during a dive, with more gas absorbed on deeper or longer dives. Even small intravascular bubbles may have physical effects, with inflammatory and thrombogenic host responses [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…To date, previous studies on DCS have mainly analyzed sports and commercial/fishery divers using underwater breathing apparatus when diving, with Jeju haenyeos included as one of the target samples for these studies. In particular, the DCS of Jeju haenyeos has different pathophysiological aspects from general DCS [ 3 , 4 ]. However, since most divers assessed in previous studies comprised those using underwater breathing apparatus, there are limitations in understanding the DCS of Jeju haenyeos from these existing studies [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Latent Class Analysis of Decompression Sickness Symptoms of Women Divers

Kim¹,

Han²

2022

Healthcare

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This study aimed to investigate the types of clinical manifestations of decompression sickness among women divers (haenyeos) in Jeju using latent class analysis and to identify factors related to the condition. A total of 527 haenyeos who received their certification in diving fishery from Jeju and were working from 15 March to 31 May 2021 were included in this study. According to the results of the study, the latent classes were classified into type 1, type 2, and mixed symptoms groups (Akaike information criterion (AIC) = 6587.29, Bayesian information criterion (BIC) = 6698.23, sample size-adjusted BIC (saBIC) = 6615.70). For personal characteristics, age (χ2 = 40.31, p < 0.001) and education level (χ2 = 28.15, p < 0.001) showed a significant difference by latent class type. For work-related characteristics, diving experience (χ2 = 29.99, p < 0.001) and break time (χ2 = 9.32, p = 0.011) showed a significant difference by latent class type. The health-related characteristics, menopausal period (χ2 = 40.10, p < 0.001), body mass index (χ2 = 14.80, p = 0.013), and fatigue level (χ2 = 58.23, p < 0.001), showed a significant difference by latent class type. Rather than approaching the management of work-related diseases simply from the work environment perspective, it is important to increase the availability of health professionals who are capable of continuous health monitoring and management of women divers in their workplace.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Latent Class Analysis of Decompression Sickness Symptoms of Women Divers

Kim¹,

Han²

2022

Healthcare

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“…Bubbles in circulation are referred to as venous gas emboli (VGE) when detected with ultrasound, where they can be seen flowing towards the lungs where they are normally dissolved/filtered out by diffusion. In rare cases, these VGE may cross from the venous to the arterial circulation through right-to-left shunts, such as a patent foramen ovale (PFO) or lung shunts ( Mitchell et al, 2022 ) ( Papadopoulou et al, 2014 ). High amounts of post-dive VGE are associated with greater risk of developing decompression sickness (DCS) ( Nishi et al, 2003 ) ( Eftedal et al, 2007 ).…”

Section: Introductionmentioning

confidence: 99%

“…The standard treatment for DCS is timely administration of oxygen to accelerate inert gas diffusion and increase partial pressure of oxygen (pO 2 ) to tissues, followed by recompression in a hyperbaric chamber, and adequate fluid management ( Chin et al, 2017 ). Inadequate or delayed treatment may result in lasting damage through mechanical disruption of neural tissue by inert gas emboli, hypoxemia through impaired perfusion, or activation of inflammatory pathways ( Mitchell et al, 2022 ) ( Newton, 2001 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Newer Hand-Held Ultrasound Devices for Post-Dive Venous gas Emboli Quantification to Standard Echocardiography

Karimpour

Brenner²,

Dong³

et al. 2022

Front. Physiol.

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Decompression sickness (DCS) can result from the growth of bubbles in tissues and blood during or after a reduction in ambient pressure, for example in scuba divers, compressed air workers or astronauts. In scuba diving research, post-dive bubbles are detectable in the venous circulation using ultrasound. These venous gas emboli (VGE) are a marker of decompression stress, and larger amounts of VGE are associated with an increased probability of DCS. VGE are often observed for hours post-dive and differences in their evolution over time have been reported between individuals, but also for the same individual, undergoing a same controlled exposure. Thus, there is a need for small, portable devices with long battery lives to obtain more ultrasonic data in the field to better assess this inter- and intra-subject variability. We compared two new handheld ultrasound devices against a standard device that is currently used to monitor post-dive VGE in the field. We conclude that neither device is currently an adequate replacement for research studies where precise VGE grading is necessary.

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Occupational decompression sickness: A case report

Diederich,

Briggs,

Malik

et al. 2024

JACEP Open

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Decompression sickness describes the clinical pathology that ensues when rapid decompression from a highly pressurized environment causes the formation of venous and extravascular inert gas bubbles. Symptoms vary widely, commonly including arthralgias, myalgias, paresthesias, and numbness. Severe and potentially life‐threatening pathology, such as neurologic impairment, cardiopulmonary instability, and gastrointestinal hemorrhage, can occur as well. Most think of diving endeavors as a common exposure predisposing to this condition, commonly referred to as “the bends.” Other occupational exposures documented in the medical literature include military training, caisson work, such as in mining and bridge construction, and hyperbaric treatment attendance. This article presents the case of a 32‐year‐old male presenting with a mottled rash, arthralgias, myalgias, headache, vision changes, and weakness, which is found to have decompression sickness secondary to occupational exposure in a factory‐based pressurized chamber. The patient underwent two hyperbaric chamber sessions with complete resolution of his symptoms. During hospitalization, he was found to have a patent foramen ovale. The patient was counseled to avoid further occupational exposure.

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Decompression Sickness and Arterial Gas Embolism

Cited by 73 publications

References 42 publications

Latent Class Analysis of Decompression Sickness Symptoms of Women Divers

Latent Class Analysis of Decompression Sickness Symptoms of Women Divers

Comparison of Newer Hand-Held Ultrasound Devices for Post-Dive Venous gas Emboli Quantification to Standard Echocardiography

Occupational decompression sickness: A case report

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