Diving Hyperb Med
-
This retrospective review examined the influence of delay to recompression on mild/moderate neurological decompression sickness (DCS) in divers, as a pilot for an abandoned prospective study. ⋯ Neither more HBOT nor a worse outcome of DCS could be related to delay to treatment longer than 17 hours. The amount of oxygen that had to be administered in total during the whole HBOT course was lower in cases that responded better to the initial HBOT.
-
Patients suffering from necrotizing fasciitis (NF) are often haemodynamically unstable and require extended monitoring of cardiovascular parameters; yet this is limited during hyperbaric oxygen treatment (HBOT). We aimed to evaluate the use and safety of transoesophageal Doppler (TED) monitoring of cardiac output (CO) under hyperbaric conditions in haemodynamically unstable patients diagnosed with NF and sepsis or septic shock. ⋯ This is, to the best of our knowledge, the first study to document that TED can provide a minimally-invasive estimate of CO in haemodynamically unstable patients with NF and sepsis or septic shock during HBOT.
-
Irukandji syndrome is a poorly defined set of symptoms that occur after envenoming by certain species of jellyfish, primarily cubozoans or 'box jellyfish'. Envenomed victims can show symptoms ranging from headaches, severe pain, nausea and vomiting to pulmonary oedema, cardiac failure and severe hypertension resulting in death. Historically, this syndrome appears to have been misdiagnosed and reported cases are undoubtedly a significant underestimation of the prevalence of this syndrome. ⋯ Although the annual numbers of envenomations are generally low, the associated financial costs of this envenomation may be comparatively high, with suggestions that it could run to millions of dollars per season in northern Australia alone. The syndrome has been well documented from many areas along the east coast of northern Australia, leading to the belief that it is an Australian oddity. However, with an increase in medical knowledge and improved diagnosis of the condition, it appears that envenomations causing Irukandji syndrome are an increasing marine problem worldwide.
-
Randomized Controlled Trial
Hyperbaric oxygen in the treatment of childhood autism: a randomised controlled trial.
Promising results with hyperbaric therapy for children with autism have been reported, but most involved the use of only mild pressure with oxygen supplementation. To date, there has been no randomised, blinded trial of 100% oxygen administered at hyperbaric pressure. This study evaluated the efficacy of hyperbaric oxygen therapy (HBOT). ⋯ Children with autism who received 20 sessions of either HBOT or a sham air exposure had significant improvements in overall behaviour but there were no significant differences in improvement between groups. The inconsistent changes on CGI sub-scores between parents and clinicians are difficult to interpret, but no overall clinically significant benefit from HBOT could be shown. Both interventions were safe and well tolerated with minimal side effect from middle ear barotraumas.
-
Comparative Study
Monitoring carbon dioxide in mechanically ventilated patients during hyperbaric treatment.
Measurement of the arterial carbon dioxide (P(a)CO(2)) is an established part of the monitoring of mechanically ventilated patients. Other ways to get information about carbon dioxide in the patient are measurement of end-tidal carbon dioxide (P(ET)CO(2)) and transcutaneous carbon dioxide (PTCCO2). Carbon dioxide in the blood and cerebral tissue has great influence on vasoactivity and thereby blood volume of the brain. We have found no studies on the correlation between P(ET)CO(2) or P(TC)CO(2), and P(a)CO(2) during hyperbaric oxygen therapy (HBOT). ⋯ During hyperbaric conditions we found that P(ET)CO(2) as opposed to P(TC)CO(2) offered the greater precision, but there was great variability among patients. Care must be taken when using P(ET)CO(2) or P(TC)CO(2) as an estimate of P(a)CO(2).