Undersea Hyperb Med [JOURNAL]
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200 papers
Efficacy of hyperbaric oxygen salvage therapy for sudden sensorineural hearing loss after ineffective primary treatment in the Slovak Republic.
Krajčovičová Z, Zigo R, Meluš V … +1 more , Králová E
Undersea Hyperb Med · 2025 · PMID 40819352
We evaluated the efficacy of hyperbaric oxygen (HBO₂) therapy used to salvage sudden sensorineural hearing loss (SSNHL) at a short distance from ineffective primary treatment. We examined the data on 70 patients who suff...
We evaluated the efficacy of hyperbaric oxygen (HBO₂) therapy used to salvage sudden sensorineural hearing loss (SSNHL) at a short distance from ineffective primary treatment. We examined the data on 70 patients who suffered from SSNHL. The treatment was administered from 1 to 3 months after the onset of the hearing loss, i.e., after ineffective primary corticosteroid therapy. The monitored group was divided into three subgroups according to the degree of hearing impairment. Treatment success was assessed by using pre- and post-treatment audiograms. A statistically significant improvement in auditory threshold in all three frequency bands was observed in patients with severe hearing impairment of more than 60 dB, with mean auditory gains of 14.5 dB in low frequencies, 11.2 dB in middle (spoken speech) frequencies, and 13.2 dB in high frequencies. In this subgroup, 54.17 % of patients with severe hearing impairment experienced an improvement in hearing gain by 5 dB or more, 33.33 % by > 10 dB, and 25.00 % by > 20 dB. In patients with moderate and slight hearing impairments, the tendency to improve the hearing gain was not statistically significant. Based on our findings, we conclude that salvage HBO₂ treatment in patients with SSNHL is apparently most efficacious for individuals with severe hearing impairment. This finding is valuable for effective resource management in healthcare and public health.
Pseudoephedrine prophylaxis does not prevent middle ear barotrauma in hyperbaric oxygen therapy.
Moayedi S, Gizaw A, Sweet S … +2 more , Sethuraman K, Witting M
Undersea Hyperb Med · 2025 · PMID 40819351
A common complication of hyperbaric oxygen (HBO₂) treatment is middle ear barotrauma (MEB), which can lead to pain, treatment abandonment, or delay in treatment. Studies have shown that pseudoephedrine decreases MEB for...
A common complication of hyperbaric oxygen (HBO₂) treatment is middle ear barotrauma (MEB), which can lead to pain, treatment abandonment, or delay in treatment. Studies have shown that pseudoephedrine decreases MEB for pressure changes in SCUBA divers and airplane travelers. We conducted a randomized, double-blind, placebo-controlled trial to determine if pseudoephedrine effectively decreases MEB rates in patients receiving their first HBO₂ treatment. There was no statistically significant difference between the pseudoephedrine and placebo groups concerning ear pain ratings, tympanic membrane injury, or rescue medication to help equalize ear pressure. Pseudoephedrine prophylaxis, given between 45 minutes and two hours before multiplace HBO₂ treatment, does not mitigate MEB or treatment delays.
Factors related to the prognosis of hyperbaric oxygen therapy for postoperative paralytic ileus.
Onodera K, Ishikawa M, Homura M … +3 more , Takahashi K, Hoshino K, Morimoto Y
Undersea Hyperb Med · 2025 · PMID 40819350
Postoperative paralytic ileus is one of the most common complications associated with abdominal surgery. Although the Japanese Society of Hyperbaric and Undersea Medicine officially approves paralytic ileus as an indicat...
Postoperative paralytic ileus is one of the most common complications associated with abdominal surgery. Although the Japanese Society of Hyperbaric and Undersea Medicine officially approves paralytic ileus as an indication for hyperbaric oxygen therapy, the factors related to the prognosis of this therapy have not been determined. Accordingly, in this study, we evaluated factors that may be related to the prognosis of this therapy in patients with postoperative paralytic ileus. Patients in gastroenterological surgery, obstetrics and gynecology, and urology who underwent hyperbaric oxygen therapy for postoperative paralytic ileus from April 1, 2017, through March 31, 2022, were retrospectively evaluated. We set the primary outcome as the number of days to oral intake after the start of the therapy. First, we compared the differences in the number of days for various factors possibly related to its prognosis. Next, multivariate analysis using multiple linear regression analysis was performed. We evaluated 110 patients. Younger age, no prevalence of diabetes mellitus, the kind of surgery, no history of previous abdominal surgery, a shorter number of days from the onset to the start of therapy, and higher mean pressure of therapy had at least 1.5 fewer days of nothing by mouth. Multiple linear regression analysis revealed that only the mean pressure of therapy was a factor associated with the prognosis of hyperbaric oxygen therapy. Only the mean pressure of therapy is related to the prognosis of hyperbaric oxygen therapy. Further prospective studies adopting higher pressure therapy will be necessary to evaluate the efficacy of this treatment.
EEG-based brain biomarker supports hyperbaric oxygen therapy for acute concussions.
Denham DW, Denham MA
Undersea Hyperb Med · 2025 · PMID 40819349
Acute concussion is a significant health issue among youth athletes, affecting their quality of life and performance. However, the standard of care, rest, has been questioned, while treatments are lacking. This pilot cas...
Acute concussion is a significant health issue among youth athletes, affecting their quality of life and performance. However, the standard of care, rest, has been questioned, while treatments are lacking. This pilot case series used an FDA-cleared electroencephalogram-based brain biomarker (EEGBB) to demonstrate hyperbaric oxygen therapy (HBO₂) improvement for treating concussion. From December 31, 2021, through May 27, 2022, school-aged patients presenting at two HBO₂ clinics within ten days of injury with an acute concussion confirmed by an initial EEGBB assessment were evaluated. The EEGBB diagnoses concussions using artificial intelligence to yield a score between 0-100, with scores ≤70 considered concussed. HBO₂ using 1.5-2.0 ATA, progressing stepwise per patient tolerance, was administered in ≥4-hour intervals until sustained symptom-free. EEGBB assessment was performed before and after each treatment. Eleven patients [mean age: 16±2.2; six male (55%)] participated. Patients presented one to nine days (median: three) after injury. Their median baseline EEGBB score was 18 (range: 1 to 35). The median first and last post-treatment scores available were 84 (range: 32-90) and 85 (range: 75-89), respectively. The median number of HBO₂ treatments was three (range: 2-8) administered over a median of two days (range: two to five). All patients except one (due to a technical error) received a post-treatment follow-up score 2- 22 days after treatment completion. The median final score was 85 (range: 64-90). There were no adverse events. Preliminary data demonstrate that the EEGBB objectively supports the use of HBO₂ to treat acute concussions. Further research should confirm the appropriate HBO₂ regimen to treat concussions.
Hyperbaric Oxygen Therapy In Surgical Site Infections: A Clinical Experience.
Özlü EBK, Aytekin Ş, Akar E … +1 more , Çalışaneller AT
Undersea Hyperb Med · 2025 · PMID 40819348
OBJECTIVE: Surgical site infections are difficult complications to manage in neurosurgery practice. We aimed to evaluate the use of hyperbaric oxygen (HBO₂) therapy in neurosurgery practice through cases followed in our...
OBJECTIVE: Surgical site infections are difficult complications to manage in neurosurgery practice. We aimed to evaluate the use of hyperbaric oxygen (HBO₂) therapy in neurosurgery practice through cases followed in our clinic. METHOD: HBO₂ therapy was performed in 13 cases between 2019-2022 at our neurosurgery clinic. We retrospectively evaluated the cases in terms of the age at the time of treatment, the primary pathology, the number of sessions in which HBO2 therapy was performed, the sedimentation and CRP values and radiological images. RESULTS: The mean age of the cases was 55.2 ± 16.4 years. Seven of the cases were female, and six of them were male. While 9 cases had infection secondary to spinal surgery performed for different indications, 1 case had wound site infection due to cranial surgery, 1 case had infection at the cranioplasty site, 1 case had infection in the area where a pain pacemaker was inserted, and 1 case had wound site infection after a carpal tunnel syndrome operation. The cases received an average of 30 sessions of HBO₂ therapy. While a significant decrease was seen in the sedimentation and CRP values, in all cases, a significant radiological improvement was seen in all the cases that were followed. In seven cases with surgical implants, there was no need for implant revision or removal. CONCLUSION: In our study, we observed that HBO₂ therapy is a good adjuvant treatment option to be used together with antibiotherapy in surgical site infections with and without implants, which are difficult to manage clinically.
Predictive modeling of the performance of the Zoll Z Vent® under hyperbaric conditions.
Winn A, Billingsley M, Pullis M … +2 more , Popa D, Logue C
Undersea Hyperb Med · 2025 · PMID 40819347
Prior work demonstrated challenges with ventilators in the hyperbaric environment; few ventilators are fully equipped to address these concerns. We hypothesized the Zoll Z-vent® would deliver set tidal volumes incorrectl...
Prior work demonstrated challenges with ventilators in the hyperbaric environment; few ventilators are fully equipped to address these concerns. We hypothesized the Zoll Z-vent® would deliver set tidal volumes incorrectly in volume control mode, but we could correct it using an algorithm. We used the Zoll Z-vent® in assist control mode in a Class A multiplace chamber and the Michigan test lung system. We identified the set tidal volumes on the ventilator that were necessary to achieve target tidal volumes at various depths. We graphed set tidal volume as a function of depth and performed linear regression modeling. From the regressions, we graphed the slope of each versus the target tidal volume and performed a second set of regressions. We generated an equation from our data to predict set tidal volumes. Set tidal volumes necessary to deliver target tidal volumes were directly proportional to depth in a linear manner. The slope of the regressions as a function of target tidal volume was also linearly proportional. The slope of the second set of regressions generated an equation that is used to predict set tidal volume for a given target tidal volume, PEEP, and gas. The Z-vent® can safely deliver mechanical ventilation under hyperbaric conditions with correction using our model. We use a spreadsheet to calculate set tidal volume for any given depth in clinical practice. We have internally validated this model on over 100 patients with multiple quality control measures in place.
Decompression Sickness: Current Recommendations.
Moon RE, Mitchell SJ
Undersea Hyperb Med · 2025 · PMID 40249722
Decompression sickness (DCS, "bends") is the clinical condition triggered by generation of bubbles in tissues or blood due to supersaturation of inert gas during or after a reduction in ambient pressure. The condition ca...
Decompression sickness (DCS, "bends") is the clinical condition triggered by generation of bubbles in tissues or blood due to supersaturation of inert gas during or after a reduction in ambient pressure. The condition can occur in association with compressed gas diving, compressed air ("caisson") work or rapid decompression to high altitude or reduced cabin pressure such as extravehicular activity (EVA) in space suits. It can also be triggered by mild reduction in ambient pressure such as during commercial aircraft flight after scuba diving. Its manifestations range from joint or muscle pain, lymphedema and skin rash to severe neurological abnormalities and cardiorespiratory collapse. Immediate evaluation should include a history of the diving/altitude event and timing of symptom onset, in addition to a careful neurological exam. Immediate treatment should include oxygen administration and appropriate resuscitation with oral or intravenous fluids; definitive treatment of DCS consists of hyperbaric oxygen. While residual manifestations may persist in severe instances, in most cases appropriate treatment results in good outcome.
Hyperbaric Treatment of Air or Gas Embolism: Current Recommendations.
Moon RE, Mitchell SJ
Undersea Hyperb Med · 2025 · PMID 40249721
Gas can enter arteries (arterial gas embolism) due to alveolar-capillary disruption (caused by pulmonary overpressurization, e.g. breath-hold ascent by divers), veins (venous gas embolism, VGE) as a result of tissue bubb...
Gas can enter arteries (arterial gas embolism) due to alveolar-capillary disruption (caused by pulmonary overpressurization, e.g. breath-hold ascent by divers), veins (venous gas embolism, VGE) as a result of tissue bubble formation due to decompression (diving, altitude exposure), or during certain surgical procedures where capillary hydrostatic pressure at the incision site is subatmospheric. Both AGE and VGE can be caused by iatrogenic gas injection. AGE usually produces stroke-like manifestations, such as impaired consciousness, confusion, seizures, and focal neurological deficits. Small amounts of VGE are often tolerated due to filtration by pulmonary capillaries; however, VGE can cause pulmonary edema, cardiac "vapor lock," and AGE due to transpulmonary passage or right-to-left shunt through a patent foramen ovale. Intravascular gas can cause arterial obstruction or endothelial damage and secondary vasospasm and capillary leak. Vascular gas is frequently not visible with radiographic imaging, which should not be used to exclude the diagnosis of AGE. Isolated VGE usually requires no treatment. AGE treatment is similar to decompression sickness (DCS), with first aid oxygen followed by hyperbaric oxygen. Although cerebral AGE (CAGE) often causes intracranial hypertension, animal studies have failed to demonstrate a benefit of induced hypocapnia. An evidence-based review of adjunctive therapies is presented.
Respiratory fitness for occupational diving, what is new?
van Ooij PJ, van Hulst RA
Undersea Hyperb Med · 2025 · PMID 40249720
Diving diseases originating from lung-related pathology are not the most prominent but are considered the most severe. To minimize this risk, a good respiratory tract assessment is important. Organizations like the Briti...
Diving diseases originating from lung-related pathology are not the most prominent but are considered the most severe. To minimize this risk, a good respiratory tract assessment is important. Organizations like the British Thoracic Society (2003) and the European Diving Technology Committee (EDTC) (2004) have provided guidelines regarding this assessment. However, most of the guidelines are 20 years old. The EDTC has revised its guidelines based on the present literature and published it last year. This review discusses a few topics that have changed or are newly introduced in the new EDTC guidelines. Importantly, additional tests might be necessary when assessing the respiratory tract based on history taking and spirometry, leading to a case-by-case decision regarding the fitness to dive. Particular attention should be paid to individuals with large lungs or cysts, those who have undergone thoracic surgery, and those with a history of asthma, immersion pulmonary edema, COVID-19 infection, or sleep apnea.
Risk assessment for divers with a history of middle ear surgery.
Weitzsäcker WE
Undersea Hyperb Med · 2025 · PMID 40249719
OBJECTIVE: Risk assessment is worked out for diving after surgery on middle ears with differentiation on different interventions such as Myringoplasty, Tympanoplasty, Mastoidectomy, Stapes surgery, and implantable hearin...
OBJECTIVE: Risk assessment is worked out for diving after surgery on middle ears with differentiation on different interventions such as Myringoplasty, Tympanoplasty, Mastoidectomy, Stapes surgery, and implantable hearing systems. METHODS: Data research was carried out via the National Library of Medicine (pubmed.ncbi.nlm.gov) and ResearchGate (researchgate.net). In the literature, no evidence-based studies were found on barotraumatic injuries after ear surgery nor on non-operated ears. Therefore, Risk assessments are based on interpreting anatomical, physiological, and physical facts, the results of pressure-exposed cadaver tests, and the studies concerning follow-up observations on post-op ears after pressure exposition. RESULTS: Critical conditions after tympanoplasty type I, temporal fascia, cartilage, perichondrium, transposition of auto-ossicles, titanium TORP and PORP, omega connector, stapes surgery, malleovestibulopexy, canal wall down (CWD) and canal wall up (CWU) after cholesteatoma, obliteration of CWD, active hearing implants CI and soundbridge are presented. Immersion depth values are represented by the pressure difference between the auditory canal and the middle ear. DISCUSSION: Tympanoplasty type I: after the complete healing process and regular tympanometry type A, the risk is not higher than in non-operated ears. Minimal burst pressure is 35 kPa (11,71 ft or 3,57 msw) when diving without Valsalva and regular tympanic membrane (TM), 30 kPa (9,84 ft or 3,0 msw) in TM with atrophic scars. PORP: same risk as type I. TORP: risk is higher than type I: burst pressure 25 kPa (8,2 ft (2,5 msw). When the stapes footplate has contact with the matrix of the cholesteatoma, diving is contraindicated. CWU: same risk as type I. CWD: contraindication for diving. Stapes surgery: same risk as for non-operated ears with regular vestibular function (verified by tympanometry).
Risk at work under pressure with medication- what do we know?
Räisänen-Sokolowski A, Eede RV, Eede MV
Undersea Hyperb Med · 2025 · PMID 40249718
Medication has become an integral part of modern life, as well as in people working in hyperbaric conditions. However, our understanding of how drugs interact with pressure variations, gas compositions, physical exertion...
Medication has become an integral part of modern life, as well as in people working in hyperbaric conditions. However, our understanding of how drugs interact with pressure variations, gas compositions, physical exertion, and physiological changes in a hyperbaric environment is very limited. Firstly, the medical condition for which a medication is being taken must be evaluated in the context of fitness for occupational diving. Secondly, the desired or adverse effect of the medication needs to be evaluated in the context of occupational diving. Some potential adverse effects include changes in alertness and cardiovascular or pulmonary functions. These can affect the fitness to dive, increase the risk of decompression illness, or mimic its symptoms. Hence, special concern must be paid to medications affecting the cardiovascular, respiratory, and central nervous systems. The purpose of this work was to evaluate what is known about commonly used drugs in the setting of occupational diving. We found that most of the data available is either anecdotal or based on recreational diving and, therefore, needs to be cautiously adapted to the working environment.
Fit for diving after musculoskeletal decompression sickness: how to detect and manage bone lesions?
Blatteau JE, Gempp E
Undersea Hyperb Med · 2025 · PMID 40249717
Musculoskeletal decompression sickness (MS DCS) is a clinical condition characterized by joint pain following scuba diving. Recent studies have shown a potential link between MS DCS and bone lesions, including dysbaric o...
Musculoskeletal decompression sickness (MS DCS) is a clinical condition characterized by joint pain following scuba diving. Recent studies have shown a potential link between MS DCS and bone lesions, including dysbaric osteonecrosis. This article highlights the importance of early detection and management of bone damage in MS DCS patients. It is recommended that a specialist diving doctor be consulted for a comprehensive assessment to ensure an accurate diagnosis and treatment plan. Ordering a joint MRI two months after the accident is the best way to detect the presence of intraosseous edema, the main risk of which is osteonecrosis, especially if the humeral or femoral head is involved. This clinical communication highlights the need for caution when resuming diving activities after MS DCS involving the shoulder or hip, as bone involvement may complicate recovery. Hyperbaric oxygen therapy sessions have been shown to have an anti-edematous effect, which can be beneficial in accelerating intraosseous healing and limiting the risk of progression to osteonecrosis. Overall, this article underscores the critical role of the diving physician in ensuring the safe return to diving for individuals recovering from MS DCS.
Occupational Medicine considerations during medical assessments for fitness to dive and for compressed air work.
Meintjes WAJ
Undersea Hyperb Med · 2025 · PMID 40249716
Most medical examinations performed on divers and compressed air workers to assess their fitness to work focus on the risks associated with exposure to increased and changing environmental pressure. However, these employ...
Most medical examinations performed on divers and compressed air workers to assess their fitness to work focus on the risks associated with exposure to increased and changing environmental pressure. However, these employees are also exposed to numerous other hazards in their workplace that may have long- and short-term health impacts. The potential adverse impact must be assessed and risk managed by companies working with a Contract Medical Advisor (CMA) assigned to the works via a Hazard Identification and Risk Assessment (HIRA) process. The appointed CMA should visit the work site to be in a position to provide adequate input into a workplace health and safety plan by directly participating in that HIRA process. A detailed analysis follows to determine whether medical surveillance would be required for hazards that are considered potential health risks. This process is reviewed with practical examples from the literature. This review does not intend to comprehensively cover all workplace hazards and risks to health associated with diving and hyperbaric operations. It aims to introduce aspects of occupational medicine and HIRA processes to Diving Medical Examiners who have not yet considered occupational hazards beyond those related to pressure. We strongly urge those doctors to work closer with the employers of divers and compressed air workers and to consider further formal study in occupational medicine. In many countries, diving medicine doctors involved with occupational divers must also have a formal occupational medicine qualification.
REPRINTED FROM THE 2023 HYPERBARIC INDICATIONS MANUAL 15 Edition:Intracranial Abscess.
Tomoye EO, Park CL, Folke L … +1 more , Moon RE
Undersea Hyperb Med · 2024 · PMID 39821772
The term "intracranial abscess" (ICA) includes cerebral abscess, subdural empyema, and epidural empyema, which share many diagnostic and therapeutic similarities and, frequently, very similar etiologies. Infection may oc...
The term "intracranial abscess" (ICA) includes cerebral abscess, subdural empyema, and epidural empyema, which share many diagnostic and therapeutic similarities and, frequently, very similar etiologies. Infection may occur and spread from a contiguous infection such as sinusitis, otitis, mastoiditis, or dental infection; hematogenous seeding; or cranial trauma. Brain abscess usually results from predisposing factors such as HIV infection, immunosuppressive drug treatment, surgery, adjacent infection (i.e., mastoiditis, sinusitis, dental infection), or systemic infection causing bacteremia. Approximately 30% to 50% of infections are caused by contiguous spread of local infections. Hematogenous spread is responsible in around a third of cases, with the mechanism for the remainder not identifiable.
REPRINTED FROM THE 2023 HYPERBARIC INDICATIONS MANUAL 15 Edition: Sudden Sensorineural Hearing Loss.
LeGros TL, Murphy-Lavoie H
Undersea Hyperb Med · 2024 · PMID 39821771
Sudden sensorineural hearing loss (SSNHL) presents as the abrupt onset of hearing loss. Approximately 88% of SSNHL has no identifiable etiology and is termed idiopathic sudden sensorineural hearing loss (ISSHL). Hearing...
Sudden sensorineural hearing loss (SSNHL) presents as the abrupt onset of hearing loss. Approximately 88% of SSNHL has no identifiable etiology and is termed idiopathic sudden sensorineural hearing loss (ISSHL). Hearing specialists have investigated ISSHL since the 1970s. Over the past 30 years, more than 800 articles, or one every two weeks, have been published in the English medical literature. ISSHL is the abrupt onset of hearing loss, usually unilaterally and upon wakening, that involves a hearing loss of at least 30 decibels (dB) occurring within three days over at least three contiguous frequencies. As most patients do not present with premorbid audiograms, the degree of hearing loss is usually defined by the presentation thresholds of the unaffected ear. Other associated symptoms include tinnitus, aural fullness, dizziness and vertigo. The historical incidence of ISSHL ranges from 5-20 cases/100,000 population, with approximately 4,000 new cases per annum in the United States. The true incidence is thought to be higher, as ISSHL is thought to be underreported. Interestingly, 4,000 cases annually calculate to 1.3 cases/ 100,000 in the United States; therefore, an incidence of 5-20/100,000 would translate to > 15,000 new ISSHL cases per annum in the United States. Recent literature has placed the annual ISSHL incidence in the United States as 27 cases/100,000, with a pediatric incidence of 11 cases/100,000. Other studies report that the incidence is increasing (160/100,000), especially in the elderly (77/100,000), and conclude that ISSHL is no longer rare. In 1984, Byl reviewed the literature and found the mean age of ISSHL presentation to be 46-49 years, with variation of incidence with age and an equal gender distribution. The presentation of ISSHL does not appear to have seasonal variations, uneven distributions of presentation throughout the year, or an association with upper respiratory infections, either prior to or following symptom onset. The spontaneous recovery is currently thought to be 30-60%.
Recovery from pulmonary oxygen toxicity: a new (ESOT) model.
Risberg J, van Ooij PJ, Mátity L
Undersea Hyperb Med · 2024 · PMID 39821770
Arieli has previously demonstrated that the exposure metric K could be used to predict pulmonary oxygen toxicity (POT) based on changes in Vital Capacity (VC). Our previous findings indicate that the Equivalent Surface O...
Arieli has previously demonstrated that the exposure metric K could be used to predict pulmonary oxygen toxicity (POT) based on changes in Vital Capacity (VC). Our previous findings indicate that the Equivalent Surface Oxygen Time (ESOT) allows the estimation of POT without loss of accuracy compared to K. In this work, we have further investigated POT recovery. The K metric assumes that the recovery of POT is to be controlled by exposure to pO. This results in a counterintuitively slow estimated recovery after exposure to low pO. Similarly, K overestimates POT during intermittent hyperoxic exposures. We used results from previous studies to train the parameters of a new ESOT recovery model. The predicted recovery of ESOT (ESOT) after initial hyperoxic exposure (ESOT) of duration t (h) and recovery time t (h) can be calculated as ESOT=ESOT · e with f=0.439 · t · 0.906. For intermittent exposures, the function ESOT(n)=(n · a · ln(b · n+1)+c) · t · pO will approximate POT (ESOT(n)) after n sessions of pO (atm) for time t (min) in each cycle. Parameters a, b, and c are specific for each cycling pattern. These ESOT functions will better predict the development of POT during intermittent hyperoxic exposures as well as recovery after a broader range of continuous hyperoxic exposures than K. We recommend limiting hyperoxic exposures in surface-oriented diving to ESOT=660, 500, and 450 for a maximum of one, five, and seven consecutive days, respectively. A minimum of 48 hours of recovery should follow. These limits can probably be relaxed for intermittent exposures.
Hyperbaric oxygen therapy for treatment of vascular occlusion after permanent dermal filler injection.
Johnson-Arbor K
Undersea Hyperb Med · 2024 · PMID 39821769
INTRODUCTION: Arterial vascular occlusion is a rare complication of dermal filler injection. This case report describes the successful use of hyperbaric oxygen therapy in a patient with vascular occlusion after a permane...
INTRODUCTION: Arterial vascular occlusion is a rare complication of dermal filler injection. This case report describes the successful use of hyperbaric oxygen therapy in a patient with vascular occlusion after a permanent dermal filler was injected. CASE REPORT: A 51-year-old woman underwent an injection of non-resorbable polymethylmethacrylate microspheres into her nasolabial folds. Several hours later, she experienced dusky discoloration of the right nasolabial fold and surrounding livedo skin changes, consistent with vascular occlusion. Treatment with warm compresses and topical nitroglycerin was initiated, and the patient was referred for hyperbaric oxygen therapy. The tissue discoloration improved significantly after the administration of six hyperbaric treatments. DISCUSSION: While hyaluronidase is recognized as a treatment option for vascular occlusion associated with using temporary fillers containing hyaluronic acid, it may also be beneficial for patients who experience vascular occlusion after administration of permanent fillers. Hyperbaric oxygen therapy, which results in hyperoxygenation of ischemic tissue and mitigation of the associated inflammatory response, may also benefit patients who experience vascular occlusion after permanent filler injection. CONCLUSIONS: Administration of hyaluronidase and hyperbaric oxygenation should be considered for patients who develop arterial occlusions after dermal filler placement, regardless of the type of injected filler.
Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss - A Comorbidity Lens.
Leder Macek AJ, Wang RS, Cottrell J … +4 more , Kay-Rivest E, McMenomey SO, Roland JT, Ross FL
Undersea Hyperb Med · 2024 · PMID 39821768
OBJECTIVE: To determine the outcomes of patients receiving hyperbaric oxygen therapy for sudden sensorineural hearing loss and the impact of patient comorbidities on outcomes. STUDY DESIGN: Retrospective chart review. SE...
OBJECTIVE: To determine the outcomes of patients receiving hyperbaric oxygen therapy for sudden sensorineural hearing loss and the impact of patient comorbidities on outcomes. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary referral center. METHODS: All patients over 18 diagnosed with sudden sensorineural hearing loss between 2018 and 2021 who were treated with hyperbaric oxygen therapy were included. Demographic information, treatment regimens and duration, and audiometric and speech perception outcomes were recorded and analyzed. RESULTS: 19 patients were included. The median age was 45 years. 53% were female and 21% had pre- existing rheumatologic disorders. The mean duration between hearing loss onset and physician visits was 9.6 days. All patients received an oral steroid course, while 95% also received a median of 3 intratympanic steroid injections. Patients began hyperbaric oxygen therapy an average of 34.2 days after the hearing loss onset for an average of 13 sessions. No significant relationships were found between patient comorbidities and outcomes. Of those who reported clinical improvement, 57% demonstrated complete recovery per Siegel's criteria. There was significant improvement after hyperbaric oxygen therapy for pure tone averages (50.3dB vs. 36.0dB, p<0.01) and word discrimination scores (73% vs 79%, p<0.05) for all patients regardless of reported clinical improvement. CONCLUSION: Hyperbaric oxygen therapy, as an adjunct to steroids, significantly improves recovery from sudden sensorineural hearing loss. The Charlson comorbidity index was not significantly associated with patient outcome, but patients with rheumatologic disorders were less likely to respond. Differentiating the natural history of the disease from hyperbaric oxygen therapy-associated improvements remains a challenge.
Does hyperbaric chamber attendance pose an asthma risk? Case report.
Demir L
Undersea Hyperb Med · 2024 · PMID 39821767
This report details a case study of a non-smoking 33-year-old female nurse who developed occupational asthma as an Inside Attendant (IA) in a hyperbaric chamber. The report analyzes the nurse's medical history, working e...
This report details a case study of a non-smoking 33-year-old female nurse who developed occupational asthma as an Inside Attendant (IA) in a hyperbaric chamber. The report analyzes the nurse's medical history, working environment, and potential causes. After beginning work in the hyperbaric chamber, an IA experienced respiratory symptoms, including coughing, wheezing, and fatigue. Her symptoms improved during a break attending a hyperbaric nursing certification program but returned when she resumed work in the IA hyperbaric chamber. Spirometry confirmed airflow obstruction, and the IA was subsequently diagnosed with occupational asthma. As a result, the IA had to terminate their employment in the hyperbaric chamber. The literature review indicates that diving and hyperbaric exposure can negatively affect respiratory function, particularly in individuals susceptible to respiratory issues. We emphasize the necessity for further research on the effects of hyperbaric exposure on the respiratory system of IAs.
Optimizing the hyperbaric chamber pressurization profile during standard hyperbaric oxygen therapy.
Mátity L, Burman F, Cronje F
Undersea Hyperb Med · 2024 · PMID 39821766
Middle ear barotrauma (MEBT) is the most common complication in providing hyperbaric oxygen therapy (HBO). This study explored the impact of altering the shape of the time-pressure curve with the aim of reducing the occu...
Middle ear barotrauma (MEBT) is the most common complication in providing hyperbaric oxygen therapy (HBO). This study explored the impact of altering the shape of the time-pressure curve with the aim of reducing the occurrence of MEBT and optimizing the HBO experience during the pressurization process. Four distinct mathematically derived protocols-Constant Pressure Difference (CPD), Constant Volume Difference (CVD), Constant Ratio (CR), and Inverted Constant Ratio (ICR)-were investigated using computer simulations on a simple ear model. Results indicated varying levels of ear strain during pressurization. The CR pressurization demonstrated balanced ear strain levels and outperformed other modalities in several measures, including the impact on the simulated ear cavity volume. The potential for enhanced patient comfort through the application of sophisticated pressurization protocols warrants further research to validate and extend the findings of this study in real-world HBO settings.
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