Undersea Hyperb Med [JOURNAL]
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200 papers
Systematic Review of Hyperbaric Oxygen for Late Radiation Tissue Injury (Bowel, Bladder).
Eckert KA, Fife CE, Carter MJ
Undersea Hyperb Med · 2025 · PMID 41223393
BACKGROUND: This systematic review evaluated comparative studies to determine if hyperbaric oxygen therapy (HBO₂) is beneficial to late radiation tissue injury (LRTI) of the bowel/bladder. METHODS: We included adequately...
BACKGROUND: This systematic review evaluated comparative studies to determine if hyperbaric oxygen therapy (HBO₂) is beneficial to late radiation tissue injury (LRTI) of the bowel/bladder. METHODS: We included adequately powered, comparative studies evaluating the effect of HBO₂ on patients with LRTI (≥3 months duration and/or ≥6 months after radiation therapy) to the bowel/bladder compared to no HBO₂ or placebo/sham; complete outcomes data must have corresponded to the tools used to measure change in LRTI symptoms. Medline was searched through May 4, 2023, Embase through May 29, 2023, and Google Scholar through May 5, 2023. The Cochrane risk-of-bias tool and GRADE approach were used with a certainty of outcomes assessment. RESULTS: Three RCTs were included with 273 subjects. Two double-blinded studies evaluated rectal symptoms; one open study evaluated cystitis. One study had a low risk of bias; two had some concerns. All had moderate certainty of outcomes. There is moderate certainty with a weak recommendation for using HBO₂ for rectal complications or cystitis, which (in context of GRADE terminology) means the decision to treat depends on a case-by-case basis. DISCUSSION: The highly heterogeneous design of the trials made meta-analysis impossible, but moderate certainty of the beneficial effect of HBO₂ on LRTI to the rectum and bladder was confirmed. With the weak recommendation, a discussion should take place between the patient and their physician as to whether or not the patient is likely to benefit from HBO₂.
Characteristic of volume-controlled ventilation with small tide volume in hyperbaric oxygen chamber.
Wang C, Zhang L, Yu Q … +3 more , Liu Y, Ren Z, Xue L
Undersea Hyperb Med · 2025 · PMID 41223392
PURPOSE: To evaluate the characteristics of tidal volume (VT) delivered by a Shangrila590 ventilator with preset tide volume (VTset) 50-300 mL in volume-controlled ventilation (VCV) during hyperbaric oxygen (HBO₂) therap...
PURPOSE: To evaluate the characteristics of tidal volume (VT) delivered by a Shangrila590 ventilator with preset tide volume (VTset) 50-300 mL in volume-controlled ventilation (VCV) during hyperbaric oxygen (HBO₂) therapy. METHODS: Experiments were conducted in a multi-place HBO₂ chamber at 1.0, 2.0, and 2.8 atmospheres absolute (ATA abs) and were divided into three groups accordingly. The ventilator was connected to the test lung in the chamber. The VTset of the ventilator was adjusted before the experiments. At five VTset levels (50, 100, 150, 200, 300 mL), the VT and inspiratory peak pressure (Ppeak) detected by the ventilator and the test lung were recorded for 30 cycles (n=30). The measurements of the test lung were considered to be the true value, and the ventilator and test lung data were compared to evaluate the accuracy of the ventilator. Test lung compliance (CTL) was detected by the ventilator, and breathing circuit compliance (CBC) was calculated by measuring the pressure and volume of the breathing circuit. Ventilation data were compared among three groups to clarify the change during HBO₂. RESULTS: At every VTset, the VT detected by the test lung was different from the ventilator at 1.0~2.8 atm abs (p<0.05), and the VT changed differently among the three groups (p<0.05). CTL and the CBC decreased with increasing ambient pressure (p<0.05). The Ppeak of VCV increased (p<0.05) with increasing ambient pressure. CONCLUSIONS: The Shangrila590 ventilator has limitations in small VTset (50- 300 mL) VCV during HBO₂ therapy. CBC and CTL levels change due to high gas density. High Ppeak may occur in VCV with stable VT, also caused by high gas density.
Impact of hyperbaric oxygen therapy on tolerability, clinical signs, lactatemia and glycemia in patients with pyometra.
Degregori EB, Caye P, Soares ABU … +9 more , Schiefler OHM, Antunes BN, Reinstein RS, Freitas J, Polanczyk VK, Mangini NP, Amancio GHS, Brun MV, Müller DCM
Undersea Hyperb Med · 2025 · PMID 41223391
This study evaluated the physical parameters, lactatemia, glycemia, and tolerability in canines with pyometra and sepsis who underwent hyperbaric oxygen therapy (HBO₂). Eighteen female dogs were randomly assigned to two...
This study evaluated the physical parameters, lactatemia, glycemia, and tolerability in canines with pyometra and sepsis who underwent hyperbaric oxygen therapy (HBO₂). Eighteen female dogs were randomly assigned to two groups: the hyperbaric group (HG) (three sequential sessions of HBO₂ [O₂ with 2 ATA for 45 min] after ovariohysterectomy) and the control group (CG) (ovariohysterectomy). Glycemia and lactatemia were measured at admission (T0), 1 hour after the end of the surgical procedure (T1), 24 hours (T2), 48 hours (T3), and 72 hours (T4) after surgery. Physical assessments were conducted at the same times, except for HG, which was assessed before and after each HBO session. There was no difference between the groups in relation to the physical parameters evaluated; however, rectal temperature was reduced in the group subjected to HBO₂. We observed an increase in lactate at T0 and T2, and a reduction at T3 and T4 in both groups. We did not identify changes in blood glucose levels. HBO₂ is acceptable and safe, but may reduce rectal temperature, although hypothermia can be expected in dogs with pyometra following the surgical procedure. Lactate may take up to 48 hours to begin, but it does not appear to be linked to prognosis or length of stay.
Risk factors and Outcome Analysis of Delayed Neurological Sequelae in elderly patients with carbon monoxide poisoning.
Ma Y, Lv W, Hu H … +2 more , Ma Y, Ma Y
Undersea Hyperb Med · 2025 · PMID 41223390
Carbon monoxide (CO) poisoning is one of the common causes of poisoning and can result in significant neurological sequelae. However, few studies have focused on the elderly population. We retrospectively reviewed elderl...
Carbon monoxide (CO) poisoning is one of the common causes of poisoning and can result in significant neurological sequelae. However, few studies have focused on the elderly population. We retrospectively reviewed elderly (age≥65 years) with CO poisoning from non-fire accidents and non-suicide at the 6th Medical Center PLA General Hospital in China from 2013 to 2023. A total of 167 patients were enrolled. The annual case number decreased from 2013 to 2023, particularly during the cold months (November to February). The most common source of exposure was coal heating (90%). The most common presenting symptoms were changes in consciousness (90%). Eighty-eight patients (52%) developed delayed neurological sequelae (DNS), of which sixty-nine (78%) converted to long-term neurological sequelae (LNS). The most common imaging manifestations were hypoxic-ischemic damage in the basal ganglia (54%) and demyelination in white matter (46%). After multivariate analysis, initial GCS score and coma time (GCS scores<8) were the independent risk factors for patients with DNS (p<0.001). Interestingly, myocardial injury was more common in non-DNS elderly patients than in DNS patients (p<0.001); only coma time was an independent risk factor for patients with LNS (p<0.001). There was no significant difference between HBO₂ (p=0.19) and NBO (p=0.38) in the occurrence of DNS and LNS in elderly patients with CO poisoning. Therefore, initial GCS score and coma time (GCS scores<8) may be the risk factors of DNS, and coma time may be a high-risk factor for poor prognosis in elderly patients with CO poisoning. Moreover, HBO₂ treatment did not show benefit or harm to those patients. Special attention should be given, and follow-up should be performed on elderly patients, particularly those who have longer coma time and CO exposure time and lower initial GCS scores in acute CO poisoning.
Hyperbaric Oxygenation Therapy as Adjunctive Treatment of Complex Wound Associated with Sterno-clavicular Septic Arthritis.
Nukala N, Rao R, Nemeth D … +1 more , Badam M
Undersea Hyperb Med · 2025 · PMID 41223389
INTRODUCTION: Sternoclavicular septic arthritis with pyomyositis is a relatively rare condition. While most cases of septic arthritis are caused by gram-positive organisms, such as Staphylococci and Streptococci spp., a...
INTRODUCTION: Sternoclavicular septic arthritis with pyomyositis is a relatively rare condition. While most cases of septic arthritis are caused by gram-positive organisms, such as Staphylococci and Streptococci spp., a small number of patients present with gram-negative organisms as the cause of their condition. Signs and symptoms can be non-specific, and although CT imaging aids in diagnosis, a timely identification relies primarily on a high index of clinical suspicion. CASE DESCRIPTION: We present a case of a 44-year-old female patient with a history of poorly controlled diabetes mellitus who presented with a chronic, non-healing wound that developed on a background of non-traumatic sternoclavicular septic arthritis, chronic osteomyelitis of the clavicle and manubrium, and concomitant pectoralis pyomyositis caused by a gram-negative pathogen. The use of HBO₂ as an addition to this patient's treatment regimen hastened the healing process. CONCLUSION: Given the rarity of this condition, we consider that adding to the body of literature with regards to the diagnosis and treatment of this condition can help clinicians develop a keen eye for it, decreasing the morbidity and mortality associated with it.
Hyperbaric Oxygen Treatment after Surgery and Radiation for Oral Cancers Does not Increase the Likelihood of a Second Primary Development, nor Reduce Disease Specific or Overall Survival.
Hsieh CH, Wen YW, Liao CT … +1 more , Lee SR
Undersea Hyperb Med · 2025 · PMID 41223388
OBJECTIVE: This study aims to analyze whether receiving Hyperbaric oxygen (HBO₂) therapy affects oral cancer prognosis using real-world data from the National Health Insurance Research Database (NHIRD) in Taiwan. METHOD:...
OBJECTIVE: This study aims to analyze whether receiving Hyperbaric oxygen (HBO₂) therapy affects oral cancer prognosis using real-world data from the National Health Insurance Research Database (NHIRD) in Taiwan. METHOD: This study is a retrospective cohort study. Cancer registration files, the NHIRD, and death statistics files from 2011 to 2019 were used for data extraction. We identified 6,297 oral cancer patients, all of whom underwent tumor resection surgery and radiation therapy. Among them, 254 patients received HBO₂ therapy for osteoradionecrosis. We then divided them into two groups for comparison based on whether they received HBO₂ therapy or not. First, propensity score matching was used to eliminate basic characteristic differences between the groups, and then Kaplan-Meier survival analysis was conducted. To eliminate immortal time bias and obtain hazard ratios, a time-dependent Cox proportional hazards model was used for estimation. RESULT: After undergoing curative tumor resection combined with adjunctive radiation therapy, oral cancer patients were divided into two groups based on whether they received hyperbaric oxygen therapy. The estimation using a time-dependent Cox proportional hazards model showed no statistically significant differences in the three follow-up endpoints of this study: incidence of second primary cancer, disease-specific mortality, and all-cause mortality, in terms of hazard ratios. CONCLUSION: In Taiwan, whether oral cancer patients receive hyperbaric oxygen therapy after curative tumor resection surgery combined with radiation therapy does not affect the incidence of second primary cancer, disease-specific mortality rate, and all-cause mortality rate.
The Experience of Hyperbaric Oxygen Therapy in Earthquake-Related Crush Injuries: Could Be Beneficial Even with Delay in Initiation.
Avcı AU, Abaylı SY
Undersea Hyperb Med · 2025 · PMID 41223387
BACKGROUND: Two significant earthquakes struck southeastern Turkey on February 6. The study aimed to evaluate the effect of HBO₂ on patients with crush injuries who received therapy at the Akyurt Hyperbaric Oxygen Therap...
BACKGROUND: Two significant earthquakes struck southeastern Turkey on February 6. The study aimed to evaluate the effect of HBO₂ on patients with crush injuries who received therapy at the Akyurt Hyperbaric Oxygen Therapy Center following the earthquakes. METHODS: Thirty-three crush injury patients were included in the study. The Gustilo crush injury grading system, the Mangled Extremity Severity Score (MESS), and the five assessment host function scores were used to evaluate patients. Additionally, the duration from the time under the rubble until HBO₂ started, as well as the presence of fasciotomy/amputation before or after HBO₂, was recorded. RESULTS: The mean duration from rescue to the initiation of HBO₂ was 195 hours. Of the patients, 63.6% were severely injured according to the MESS (≥7). The Gustilo crush injury classification distribution was 30.3% IIIC, 42.4% IIIB, and 27.3% IIIA. Before HBO₂, 87.9% of the patients had fasciotomies. Fasciotomy lines were closed (without requiring another fasciotomy or additional complications) during or immediately after HBO₂ in 72.4% of 29 patients. Following HBO₂, 78.8% of the patients did not require amputation, while 21.2% had amputations. All patients who underwent amputation after HBO₂ were in the Gustilo IIIC group and scored MESS ≥ 7. Furthermore, 71.4% of patients who had an amputation scored MESS ≥ 10. CONCLUSIONS: Hyperbaric oxygen therapy is beneficial in limb salvage and reduces complications in crush injuries and should be included in treatment plans. In countries with active tectonic activity, appropriate planning should be implemented to ensure patients' access to HBO₂, and the number of HBO₂ centers should be increased.
A Scoping Review of the Equivalent Air Depth Concept.
Risberg J, Segadal K, Gennser M
Undersea Hyperb Med · 2025 · PMID 41223386
Surface-oriented diving with nitrogen-oxygen breathing gases (nitrox) other than air will commonly be planned according to the Equivalent Air Depth (EAD) principle. EAD is the depth at which a diver breathing air will in...
Surface-oriented diving with nitrogen-oxygen breathing gases (nitrox) other than air will commonly be planned according to the Equivalent Air Depth (EAD) principle. EAD is the depth at which a diver breathing air will inhale the same pN₂ as the nitrox-breathing diver. Using conventional air decompression tables based on the EAD depth will allow longer bottom times or shorter decompression times compared to air breathing at the same water depth. This scoping review aimed to investigate the validity of the EAD principle. A literature review identified 13 eligible studies that reported DCS incidence or vascular bubbles following air and nitrox exposures in humans and experimental animals. Four experimental (N=1,597 mandives) and two epidemiological (N=249,109 mandives) studies on humans did not disclose a higher DCS incidence or bubble scores following nitrox dives compared to air dives of similar EAD. Seven experimental animal studies consistently showed that a high pO₂ (>2 atm) increased DCS susceptibility in goats and rats. This can likely be explained by the reduction of the "oxygen window" due to the high tissue and venous pO₂. There is insufficient data from animal studies to conclude whether this can be reproduced within a pO₂ range applicable for human operational diving (<1.6 atm). There is presently no reason to modify the EAD principle for manned diving. Still, we would advise improving the monitoring of operational nitrox dives to confirm that nitrox dives have a DCS incidence similar to that of EAD- and bottom time-matched air dives.
Arterial Gas Embolism after breath-hold diving. An interesting case report in Greece.
Athanasiou K, Sotiropoulos G, Kalentzos VN
Undersea Hyperb Med · 2025 · PMID 41223385
BACKGROUND: Pulmonary overinflation syndrome (POIS) is a group of barotrauma-related conditions caused by the expansion of gas trapped in the lung or over-pressurization of the lung with subsequent overexpansion and rupt...
BACKGROUND: Pulmonary overinflation syndrome (POIS) is a group of barotrauma-related conditions caused by the expansion of gas trapped in the lung or over-pressurization of the lung with subsequent overexpansion and rupture of the alveolar air sacs. We report a case in which neurological sequelae (arterial gas embolism-AGE) and pneumothorax occurred after breath-hold diving. Treatment with Hyperbaric Oxygen Therapy (HBO₂) led to resolution. CASE REPORT: A 20-year-old male diver was transferred to the Athens Naval Hospital with symptoms after breath-hold diving. He developed neurological deficits presenting as reduced visual acuity and hemiparesis, along with subcutaneous emphysema, pneumomediastinum, and bilateral pneumothoraces. The treatment strategy involved initial management of the pneumothorax, followed by HBO₂ combined with medication to resolve the neurological injury. The patient's clinical improvement was remarkable a week later, and he was discharged.
Oxy-inflammation after repetitive "open circuit" dives in the Baltic Sea.
Brizzolari A, Mrakic-Sposta S, Vezzoli A … +5 more , Balestra C, Bonini B, Barassi A, Camporesi E, Bosco G
Undersea Hyperb Med · 2025 · PMID 41223384
BACKGROUND: SCUBA diving involves exposure to a hyperbaric environment that can induce oxidative stress and inflammation. This study investigates the evolution of oxy-inflammation status in divers who performed repetitiv...
BACKGROUND: SCUBA diving involves exposure to a hyperbaric environment that can induce oxidative stress and inflammation. This study investigates the evolution of oxy-inflammation status in divers who performed repetitive dives in cold water. METHODS: In the Baltic Sea, nine expert divers were recruited to perform five dives (T1-T5). Urine and saliva were collected before (A) and after (B) each dive. Reactive Oxygen Species (ROS), total antioxidant capacity (TAC), lipid peroxidation (8-iso-PGF2α), DNA damage (8-OH-dG), inflammatory status (IL-6), nitric oxide metabolites, neopterin, and electrolyte balance changes were investigated. RESULTS: Pre-dive values showed significant increases at the fourth to fifth days in ROS (+45 and +89%) and consequently in lipid peroxidation (+65%) at the fourth day and in DNA damage (+49 and +61%) at the fourth to fifth days, respectively, compared to the first day value. Post-dive significant increases were recorded at the fourth to fifth days in ROS (+83 % and +146%), and at the fifth day in lipid peroxidation (+59%) and DNA damage (+41%) with respect to the post-dive value of the first day. TAC showed a decrease from the fourth to fifth days post-dive (-15% and -24%) compared to the value on the first day post-dive. Finally, IL-6 increased at the basal level of the fifth day (+183%) and post dive (+154%) with respect to the corresponding values of the first day. CONCLUSION: Repetitive dives in cold water induced a progressive increase in pre-dive ROS, 8-iso-PGF2α, 8-OH-dG, and IL-6. Oxidative stress was only partially contained by activation of endogenous antioxidant defenses, while IL-6 variation resulted from diving-related physical effort or oxy-inflammation. We did not find notable changes in the electrolyte balance, probably because all subjects examined were well- trained and experienced divers.
Clostridial Myonecrosis (Gas Gangrene).
Weenink RP, Giannakopoulos GF, van Hulst RA
Undersea Hyperb Med · 2025 · PMID 40819362
Clostridial myositis and myonecrosis, or gas gangrene, is an acute, rapidly progressive, non-pyogenic, invasive clostridial infection of the muscle tissue characterized by profound toxemia, extensive edema, massive death...
Clostridial myositis and myonecrosis, or gas gangrene, is an acute, rapidly progressive, non-pyogenic, invasive clostridial infection of the muscle tissue characterized by profound toxemia, extensive edema, massive death of tissue, and a variable degree of gas production [1-2]. Gas gangrene is either an endogenous infection caused by contamination from a clostridial focus in the body (spontaneous, atraumatic) or an exogenous infection found mostly in patients with compound and/or complicated fractures with extensive soft tissue injuries after trauma (non-spontaneous, traumatic). The onset of gas gangrene may occur between one to six hours after injury or operation and begins with severe and sudden pain in the infected area before the clinical signs appear. In atraumatic clostridial myonecrosis there are certain predisposing risks such as colonic and gynecologic malignancy, radiation, chemotherapy, and neutropenia. Seemingly disproportionate pain in a clinically still-normal area must make the clinician highly suspicious for developing gas gangrene, especially after trauma or operation. In the early phases, the skin overlying the infected area appears shiny and tense. In the next phase it becomes dusky and progresses to a bronze discoloration. The infection can advance very rapidly, and the patient may become moribund within 12 hours [3]. Hemorrhagic bullae or vesicles may be noted. A thin, serosanguinolent exudate with a sickly, sweet odor is present. Swelling and edema of the infected area is pronounced. The muscles appear dark red to black or greenish. They are noncontractile and do not bleed when cut. The tissue gas seen on radiographs appears as featherlike figures between muscle fibers and is an early and highly characteristic sign of clostridial myonecrosis. Crepitus is usually present as well. Systemic toxicity presents as high fever and tachycardia, followed by shock and multiorgan failure [3].
Arterial Insufficiencies: Central Retinal Artery Occlusion.
Murphy-Lavoie H, Butler F, Hagan C
Undersea Hyperb Med · 2025 · PMID 40819361
Central retinal artery occlusion (CRAO) is a relatively rare emergent condition of the eye resulting in sudden painless vision loss. This vision loss is usually dramatic and permanent, and the prognosis for visual recove...
Central retinal artery occlusion (CRAO) is a relatively rare emergent condition of the eye resulting in sudden painless vision loss. This vision loss is usually dramatic and permanent, and the prognosis for visual recovery is poor. Patients particularly at risk include those with giant cell arteritis, atherosclerosis, and thromboembolic disease. A wide variety of treatment modalities have been tried over the last one hundred years with little to no success, with the exception of hyperbaric oxygen therapy (HBO₂).
Should We Abstain from Routine Use of Radiologic Imaging in Fitness to Dive Assessments? A call for action.
Lindholm P, Wingelaar T
Undersea Hyperb Med · 2025 · PMID 40819360
This article calls for a critical reevaluation of routine radiologic imaging, particularly chest X-rays (CXR) and chest computed tomography (CT), in fitness-to-dive assessments for occupational, military, and commercial...
This article calls for a critical reevaluation of routine radiologic imaging, particularly chest X-rays (CXR) and chest computed tomography (CT), in fitness-to-dive assessments for occupational, military, and commercial divers. While these assessments aim to prevent diving incidents by identifying medical risks, the frequent inclusion of radiologic imaging for asymptomatic divers raises concerns due to limited sensitivity and specificity, incidental findings, and potential disqualification without clear evidence of increased diving-related risk. The authors advocate for a community-driven consensus to establish evidence-based guidelines and address the necessity of routine imaging in this context.
Technical Suitability of Implantable Cardiac Devices for Recreational Diving.
Paganini M, Tarsia L, Bosco G … +7 more , Camporesi EM, Biffi M, Martignani C, Ziacchi M, Boriani G, Vitolo M, Diemberger I
Undersea Hyperb Med · 2025 · PMID 40819359
BACKGROUND: Diving is a diffused recreational activity, and the number of divers carrying cardiac implanted devices is similarly growing. Due to the lack of guidelines or technical indications, the suitability of such de...
BACKGROUND: Diving is a diffused recreational activity, and the number of divers carrying cardiac implanted devices is similarly growing. Due to the lack of guidelines or technical indications, the suitability of such devices for diving or the fitness to dive for these patients still needs to be determined. OBJECTIVE: This work summarizes implantable cardiac devices' suitability for recreational diving, technical vulnerability factors, and recommendations to improve implanted divers' safety. METHODS: Between May 1, 2021, and March 20, 2022, three interventional cardiologists retrieved the technical documentation of selected implantable cardiac devices. In particular, any suitability and tests conducted in hyperbaric environments were tracked. RESULTS: Technical documentation was recovered for four companies. Most devices were tested in hyperbaric conditions in single, prolonged, or repeated exposures to pressurized air; underwater tests were not mentioned. No company expressly disclosed the suitability of the devices for underwater activities. CONCLUSION: In the absence of technical indications or guidelines, a multidisciplinary evaluation between cardiology, diving medicine, and sports medicine is essential to establish the suitability for underwater sports in implanted patients. Before each diving trip, device control is advisable, and underwater physiological adaptations should be considered, especially in the cardiovascular domain. Stressors other than water and pressure must be considered during diving, such as lead strain caused by arm movements and pressure exerted by suits or buoyancy control devices on the chest. Future directions point towards a follow-up of implanted, active divers and developing leadless devices and underwater telemonitoring.
Effect of hyperbaric air exposure with prolonged oxygen inhalation during decompression on the cardiovascular function in divers.
Wenwu L, Tingting Z, Lijun Y … +3 more , Jiajun X, Xuhua Y, Shifeng W
Undersea Hyperb Med · 2025 · PMID 40819358
OBJECTIVE: This study aimed to evaluate the effect of prolonged oxygen inhalation during decompression on the cardiovascular function in divers with hyperbaric air exposure. METHODS: Eight divers were pressurized to 400...
OBJECTIVE: This study aimed to evaluate the effect of prolonged oxygen inhalation during decompression on the cardiovascular function in divers with hyperbaric air exposure. METHODS: Eight divers were pressurized to 400 kPa and then depressurized 30 minutes later. During the decompression, the time of oxygen breathing was prolonged at different depths. The cardiac, carotid, and brachial arterial functions were evaluated by ultrasonography immediately before and after exposure and then compared. RESULTS: After hyperbaric exposure, diastolic blood pressure increased significantly, heart rate reduced markedly, but systolic blood pressure tended to reduce. The peak systolic velocity and end diastolic velocity of the common carotid artery reduced markedly, but its resistance index slightly increased, and the diameter of the brachial artery tended to increase. In addition, the end-diastolic volume, cardiac output, E wave, and A wave of the heart reduced markedly, but the flow velocity of the pulmonary artery tended to reduce. CONCLUSION: Hyperbaric air exposure at 400 kPa with prolonged oxygen inhalation during decompression mildly affects divers' cardiovascular function.
Position change during hyperbaric oxygen therapy for arterial gas embolism.
Jingami N, Nitta T, Ishiguro Y … +3 more , Takatani Y, Yunoki T, Ohtsuru S
Undersea Hyperb Med · 2025 · PMID 40819357
Arterial gas embolism can be fatal and should be treated with care. Typically, the patient is placed in the supine position during treatment. However, we present a case where the patient's position was changed to facilit...
Arterial gas embolism can be fatal and should be treated with care. Typically, the patient is placed in the supine position during treatment. However, we present a case where the patient's position was changed to facilitate treatment. A 78-year-old man with severely reduced heart function underwent cryoablation for chronic atrial fibrillation. During the procedure, he accidentally inhaled rapidly. Subsequently, he presented with stroke symptoms. Computed tomography (CT) revealed air in the brain and left ventricle, leading to a diagnosis of arterial gas embolism. He underwent hyperbaric oxygen (HBO₂) therapy as per the US NAVY Table 6 protocol. The air embolism in the brain reduced but that in the apex of the left ventricle persisted. Subsequently, HBO₂, as per the US NAVY Table 5 protocol, was performed along with a position change to the right lateral and manual vibration. The position change was based on the three-dimensional structures of the left ventricle, aortic arch, and descending aorta. Subsequently, no air was observed on CT, and rehabilitation was initiated. Safe body positions for arterial and venous gas embolisms differ. Therefore, understanding the vascular anatomy is imperative for treating gas embolism.
The Role of Hyperbaric Oxygen Therapy for Severe Frostbite Injury: Insights from a Retrospective Cohort at a High Volume Burn Center.
Masters T, Samson M, Tucci J … +5 more , Lacey AM, Rogers C, Coward A, Punjab GV, Nygaard RM
Undersea Hyperb Med · 2025 · PMID 40819356
This retrospective study examines the effectiveness of Hyperbaric oxygen therapy in treating severe frostbite injuries. From October 2013 to March 2020, the study analyzed 214 patients, including 62 treated with HBO₂ the...
This retrospective study examines the effectiveness of Hyperbaric oxygen therapy in treating severe frostbite injuries. From October 2013 to March 2020, the study analyzed 214 patients, including 62 treated with HBO₂ therapy. This study aims to describe the impact of HBO₂ therapy on improving tissue salvage and reducing amputation rates in severe frostbite-injured patients. The data suggested that patients undergoing HBO₂ therapy were more likely to receive thrombolytics and have larger areas of tissue impacted. They tended to be younger and had longer hospital stays. A significantly larger proportion of HBO₂ therapy-treated patients required surgical interventions, including amputation and debridement, compared to those not treated with HBO₂ therapy, reflecting the severity of their initial injury. Results indicate a complex relationship between HBO₂ therapy treatment and patient outcomes, suggesting that factors such as severity of injury, patient demographics, and thrombolytic therapy treatment significantly influence severe frostbite outcomes. This study contributes valuable insights to the limited literature on HBO₂ therapy in frostbite management and underscores the need for further controlled trials to ascertain its effectiveness conclusively.
Visualization and Bibliometric Analysis of the Research Progress and Trends of Air Embolism.
Ma Y, Lv W, Pan S … +1 more , Guo D
Undersea Hyperb Med · 2025 · PMID 40819355
OBJECTIVE: The etiology and diagnosis of air embolism (AE), including approaches for prevention and management based on experimental and clinical data, have been presented. However, these publications may not reach all t...
OBJECTIVE: The etiology and diagnosis of air embolism (AE), including approaches for prevention and management based on experimental and clinical data, have been presented. However, these publications may not reach all the intended audience (e.g., surgeons), and thus, the use of bibliometric analyses is encouraged. METHODS: We queried the Web of Science database using bibliometric analysis to identify publications related to AE from 1995 to 2022. RESULTS: The literature search retrieved 2463 publications that met the inclusion criteria. In AE research, the total number of articles published every year was 80±16, and it increased gradually in recent years. Many published articles and most of the top ten research institutions (8/10) were from the USA (n = 826, 33.5%). The USA also has the highest citations and the most extensive cooperation with most countries. However, the proportion of the top ten journals is not too high, and the quality of these papers is not sufficiently good. The mean number of citations for the top ten articles was 105.8 (range: 68-298). Moreover, ten authors contributed to 146 manuscripts from eight countries. A total of 7926 keywords were found. Among these, 135 were hotspot keywords that appeared at least 20 times. The keywords with strong citation bursts changed from dog to risk factors of AE (7.66 versus 9.81). CONCLUSIONS: We explore the citation relevance and collaboration map and their hotspots in AE and provide a foundational understanding of the research progress and trends of AE.
Definition of delayed-onset neurologic sequelae: A review article.
Dakessian A, Hagen Z, Rocksmith ER … +1 more , Sethuraman KN
Undersea Hyperb Med · 2025 · PMID 40819354
BACKGROUND: Delayed-onset neurologic sequelae (DNS) is a devastating complication of carbon monoxide poisoning. Despite abundant research studies on DNS, the definition remains unclear, with a wide range of symptoms. Thi...
BACKGROUND: Delayed-onset neurologic sequelae (DNS) is a devastating complication of carbon monoxide poisoning. Despite abundant research studies on DNS, the definition remains unclear, with a wide range of symptoms. This review aims to identify the different symptoms and definitions that have been associated with DNS in available research. METHODS: For this review, searches were conducted in PubMed and Scopus. Two authors screened research studies by abstract and title, and a third resolved conflicts. After the full-text review, one author extracted the data. Only original full-text research studies in English with a clear definition of DNS were included. RESULTS: This review included 127 studies. Signs and symptoms associated with DNS were categorized into twelve groups. The most used symptom categories to define DNS were general neurological and cognitive/learning dysfunctions. Imaging studies, clinical testing, and neuropsychiatric testing used to define DNS were also documented. CONCLUSIONS: The literature did not consistently define DNS attributed to CO toxicity. Standardizing the definition and diagnostic criteria would benefit clinical research.
Arterial Gas Embolism After CT-Guided Lung Biopsy.
Zhu W, Moayedi S, Sethuraman K
Undersea Hyperb Med · 2025 · PMID 40819353
Arterial gas embolism (AGE) is a rare complication of percutaneous lung biopsy. We report a case of a patient undergoing lung biopsy complicated by AGE and transient ventricular tachycardia. The patient was placed in the...
Arterial gas embolism (AGE) is a rare complication of percutaneous lung biopsy. We report a case of a patient undergoing lung biopsy complicated by AGE and transient ventricular tachycardia. The patient was placed in the Trendelenburg position, treated with normobaric oxygen therapy, and ultimately discharged from the emergency department. We review the evidence regarding optimal patient positioning for AGE management.
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