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Comparing the EMMA capnograph with sidestream capnography and arterial carbon dioxide pressure at 284 kPa. 比较 EMMA 毛细血管通气记录仪与侧流毛细血管通气记录仪以及 284 千帕的动脉二氧化碳压力。
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.327-332
Xavier Ce Vrijdag, Hanna van Waart, Chris Sames, Jamie W Sleigh, Simon J Mitchell

Introduction: Capnography aids assessment of the adequacy of mechanical patient ventilation. Physical and physiological changes in hyperbaric environments create ventilation challenges which make end-tidal carbon dioxide (ETCO2) measurement particularly important. However, obtaining accurate capnography in hyperbaric environments is widely considered difficult. This study investigated the EMMA capnograph for hyperbaric use.

Methods: We compared the EMMA capnograph to sidestream capnography and the gold standard arterial carbon dioxide blood gas analysis in a hyperbaric chamber. In 12 resting subjects breathing air at 284 kPa, we recorded ETCO2 readings simultaneously derived from the EMMA and sidestream capnographs during two series of five breaths (total 24 measurements). An arterial blood gas sample was also taken simultaneously in five participants.

Results: Across all measurements there was a difference of about 0.1 kPa between the EMMA and sidestream capnographs indicating a very slight over-estimation of ETCO2 by the EMMA capnograph, but fundamentally good agreement between the two end-tidal measurement methods. Compared to arterial blood gas pressure the non-significant difference was about 0.3 and 0.4 kPa for the EMMA and sidestream capnographs respectively.

Conclusions: In this study, the EMMA capnograph performed equally to the sidestream capnograph when compared directly, and both capnography measures gave clinically acceptable estimates of arterial PCO2.

导言:二氧化碳呼气监测有助于评估患者机械通气的充分性。高压氧环境中的物理和生理变化给通气带来了挑战,因此潮气末二氧化碳(ETCO2)的测量尤为重要。然而,人们普遍认为在高压氧环境中很难获得准确的毛细血管造影。本研究调查了用于高压氧环境的 EMMA 毛细血管通气记录仪:我们在高压氧舱中将 EMMA 毛细血管通气记录仪与侧流毛细血管通气记录仪和黄金标准动脉二氧化碳血气分析仪进行了比较。在 12 名呼吸 284 kPa 空气的静息受试者身上,我们同时记录了 EMMA 和侧流毛细血管通气记录仪在两次 5 次呼吸过程中得出的 ETCO2 读数(共 24 次测量)。我们还同时采集了五名参与者的动脉血气样本:在所有测量中,EMMA 和侧流毛细血管通气记录仪之间的差值约为 0.1 kPa,这表明 EMMA 毛细血管通气记录仪对 ETCO2 的估计略有偏高,但两种潮气末测量方法之间的一致性基本良好。与动脉血气压相比,EMMA 和侧流毛细血管通气记录仪的非显著性差异分别约为 0.3 和 0.4 kPa:在这项研究中,直接比较时,EMMA 毛细血管通气记录仪与侧流毛细血管通气记录仪的性能相当,两种毛细血管通气记录仪都能提供临床上可接受的动脉 PCO2 估计值。
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引用次数: 0
Hyperbaric oxygen treatment in delayed post-hypoxic encephalopathy following inhalation of liquefied petroleum gas: a case report. 吸入液化石油气后迟发性缺氧后脑病的高压氧治疗:病例报告。
IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.351-355
Kubra Canarslan Demir, Burak Turgut, Kubra Ozgok Kangal, Taylan Zaman, Kemal Şimşek

Delayed post-hypoxic encephalopathy can occur after an episode of anoxia or hypoxia. Symptoms include apathy, confusion, and neurological deficits. We describe a 47-year-old male patient who inhaled gas from a kitchen stove liquid petroleum gas cylinder. He was diagnosed with hypoxic ischaemic encephalopathy 12 hours after his emergency department admission. He received six sessions of hyperbaric oxygen treatment (HBOT) and was discharged in a healthy state after six days. Fifteen days later, he experienced weakness, loss of appetite, forgetfulness, depression, balance problems, and inability to perform self-care. One week later, he developed urinary and fecal incontinence and was diagnosed with post-hypoxic encephalopathy. After 45 days from the onset of symptoms, he was referred to the Underwater and Hyperbaric Medicine Department for HBOT. The patient exhibited poor self-care and slow speech rate, as well as ataxic gait and dysdiadochokinesia. Hyperbaric oxygen was administered for twenty-four sessions, which significantly improved the patient's neurological status with only hypoesthesia in the left hand remaining at the end of treatment. Hyperbaric oxygen has been reported as successful in treating some cases of delayed neurological sequelae following CO intoxication. It is possible that HBO therapy may also be effective in delayed post-hypoxic encephalopathy from other causes. This may be achieved through mechanisms such as transfer of functional mitochondria to the injury site, remyelination of damaged neurons, angiogenesis and neurogenesis, production of anti-inflammatory cytokines, and balancing of inflammatory and anti-inflammatory cytokines.

缺氧或缺氧发作后会出现延迟性缺氧后脑病。症状包括淡漠、意识模糊和神经功能缺损。我们描述了一名 47 岁的男性患者,他吸入了厨房炉灶液化石油气钢瓶中的气体。他在急诊科入院 12 小时后被诊断为缺氧缺血性脑病。他接受了六次高压氧治疗(HBOT),六天后健康出院。15 天后,他出现乏力、食欲不振、健忘、抑郁、平衡障碍和生活不能自理等症状。一周后,他出现大小便失禁,被诊断为缺氧后脑病。症状出现 45 天后,他被转诊到水下和高压氧医学科接受 HBOT 治疗。患者表现出自理能力差、语速缓慢、共济失调步态和运动障碍。高压氧治疗持续了 24 个疗程,显著改善了患者的神经状况,治疗结束时患者仅剩左手感觉减退。据报道,高压氧可成功治疗一些一氧化碳中毒后迟发性神经系统后遗症病例。高压氧疗法也可能对其他原因引起的延迟性缺氧后脑病有效。这可能是通过将功能线粒体转移到损伤部位、受损神经元再髓鞘化、血管生成和神经再生、产生抗炎细胞因子以及平衡炎症和抗炎细胞因子等机制实现的。
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引用次数: 0
Full-face snorkel masks increase the incidence of hypoxaemia and hypercapnia during simulated snorkelling compared to conventional snorkels. 与传统呼吸管相比,全脸呼吸管面罩会增加模拟呼吸过程中低氧血症和高碳酸血症的发生率。
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.313-320
Janneke Grundemann, Xavier Ce Vrijdag, Nicole Ye Wong, Nicholas Gant, Simon J Mitchell, Hanna van Waart

Introduction: Air flow in full-face snorkel masks (FFSMs) should be unidirectional to prevent rebreathing of exhaled air. This study evaluated rebreathing and its consequences when using FFSMs compared to a conventional snorkel.

Methods: In a dry environment 20 participants wore three types of snorkel equipment in random order: Subea Easybreath FFSM; QingSong 180-degree panoramic FFSM; and a Beuchat Spy conventional snorkel (with nose clip), in three conditions: rest in a chair; light; and moderate intensity exercise on a cycle ergometer. Peripheral oxygen saturation, partial pressure of carbon dioxide (PCO2) and oxygen (PO2) in the end tidal gas and FFSM eye-pockets, respiratory rate, minute ventilation, were measured continuously. Experiments were discontinued if oxygen saturation dropped below 85%, or if end-tidal CO2 exceeded 7.0 kPa.

Results: Experimental runs with the FFSMs had to be discontinued more often after exceeding 7.0 kPa end-tidal CO2 compared to a conventional snorkel e.g., 18/40 (45%) versus 4/20 (20%) during light intensity exercise, and 9/22 (41%) versus 3/16 (19%) during moderate intensity exercise. Thirteen participants exhibited peripheral oxygen saturations below 95% (nine using FFSMs and four using the conventional snorkel) and five fell below 90% (four using FFSMs and one using the conventional snorkel). The PCO2 and PO2 in the eye-pockets of the FFSMs fluctuated and were significantly higher and lower respectively than in inspired gas, which indicated rebreathing in all FFSM wearers.

Conclusions: Use of FFSMs may result in rebreathing due to non-unidirectional flow, leading to hypercapnia and hypoxaemia.

简介:全脸呼吸面罩(FFSM)中的气流应该是单向的,以防止呼出的空气倒吸。本研究评估了与传统呼吸管相比,使用 FFSM 时的反呛气及其后果:在干燥的环境中,20 名参与者按随机顺序佩戴了三种呼吸管设备:Subea Easybreath FFSM、QingSong 180 度全景式 FFSM 和 Beuchat Spy 传统呼吸管(带鼻夹),在三种条件下使用:在椅子上休息;轻度;在自行车测力计上进行中等强度运动。连续测量外周血氧饱和度、潮气末和 FFSM 眼袋中的二氧化碳分压 (PCO2) 和氧气分压 (PO2)、呼吸频率和分钟通气量。如果血氧饱和度低于 85%,或潮气末二氧化碳超过 7.0 千帕,则停止实验:结果:与传统呼吸管相比,使用 FFSM 的实验运行在潮气末二氧化碳超过 7.0 kPa 后需要中断的次数更多,例如,在轻度强度运动中,18/40(45%)对 4/20(20%);在中度强度运动中,9/22(41%)对 3/16(19%)。13 名参与者的外周血氧饱和度低于 95%(9 人使用 FFSM,4 人使用传统呼吸管),5 人低于 90%(4 人使用 FFSM,1 人使用传统呼吸管)。FFSM 眼袋中的 PCO2 和 PO2 有所波动,分别明显高于和低于吸入的气体,这表明所有 FFSM 佩戴者都存在反呼吸现象:结论:使用 FFSM 可能会因气流的非单向性而导致反呼吸,从而导致高碳酸血症和低氧血症。
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引用次数: 0
University of Auckland Postgraduate Diploma in Diving and Hyperbaric Medicine. 奥克兰大学潜水和高压氧医学研究生文凭。
IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.360
Michael Davis
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引用次数: 0
Hypoxic loss of consciousness in air diving: two cases of mixtures made hypoxic by oxidation of the scuba diving cylinder. 空气潜水中的缺氧性意识丧失:两个因潜水气瓶氧化而导致混合物缺氧的案例。
IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.356-359
Arnaud Druelle, Lucille Daubresse, Jean U Mullot, Hélène Streit, Pierre Louge

Without an adequate supply of oxygen from the scuba apparatus, humans would not be able to dive. The air normally contained in a scuba tank is dry and free of toxic gases. The presence of liquid in the tank can cause corrosion and change the composition of the gas mixture. Various chemical reactions consume oxygen, making the mixture hypoxic. We report two cases of internal corrosion of a scuba cylinder rendering the respired gas profoundly hypoxic and causing immediate hypoxic loss of consciousness in divers.

如果水肺设备不能提供充足的氧气,人类就无法潜水。水肺罐中通常含有干燥且不含有毒气体的空气。水肺舱中液体的存在会导致腐蚀,并改变混合气体的成分。各种化学反应会消耗氧气,使混合气体缺氧。我们报告了两起水肺气瓶内部腐蚀导致呼吸气体严重缺氧并使潜水员立即缺氧失去知觉的案例。
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引用次数: 0
Cerebral arterial gas embolism (CAGE) during open water scuba certification training whilst practising a controlled emergency swimming ascent. 在开放水域水肺认证培训中,在练习受控紧急游泳上升时发生脑动脉气体栓塞 (CAGE)。
IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.345-350
Neil Banham, Elisabete da Silva, John Lippmann

We report the case of a 23-year-old male novice diver who sustained cerebral arterial gas embolism (CAGE) during his open water certification training whilst practising a free ascent as part of the course. He developed immediate but transient neurological symptoms that had resolved on arrival to hospital. Radiological imaging of his chest showed small bilateral pneumothoraces, pneumopericardium and pneumomediastinum. In view of this he was treated with high flow normobaric oxygen rather than recompression, because of the risk of development of tension pneumothorax upon chamber decompression. There was no relapse of his neurological symptoms with this regimen. The utility and safety of free ascent training for recreational divers is discussed, as is whether a pneumothorax should be vented prior to recompression, as well as return to diving following pulmonary barotrauma.

我们报告了一例 23 岁男性新手潜水员的病例,他在开放水域认证培训期间,在作为课程一部分的自由上升练习中发生了脑动脉气体栓塞(CAGE)。他立即出现了短暂的神经症状,但在送往医院时症状已经缓解。胸部影像学检查显示他患有双侧小气胸、气胸和气腹。有鉴于此,他接受了高流量常压氧治疗,而不是再次减压,因为腔室减压有可能导致张力性气胸。采用这种治疗方案后,他的神经症状没有复发。本文讨论了休闲潜水员进行自由上升训练的实用性和安全性,以及气胸是否应在减压前排气,以及肺气压创伤后恢复潜水的问题。
{"title":"Cerebral arterial gas embolism (CAGE) during open water scuba certification training whilst practising a controlled emergency swimming ascent.","authors":"Neil Banham, Elisabete da Silva, John Lippmann","doi":"10.28920/dhm53.4.345-350","DOIUrl":"10.28920/dhm53.4.345-350","url":null,"abstract":"<p><p>We report the case of a 23-year-old male novice diver who sustained cerebral arterial gas embolism (CAGE) during his open water certification training whilst practising a free ascent as part of the course. He developed immediate but transient neurological symptoms that had resolved on arrival to hospital. Radiological imaging of his chest showed small bilateral pneumothoraces, pneumopericardium and pneumomediastinum. In view of this he was treated with high flow normobaric oxygen rather than recompression, because of the risk of development of tension pneumothorax upon chamber decompression. There was no relapse of his neurological symptoms with this regimen. The utility and safety of free ascent training for recreational divers is discussed, as is whether a pneumothorax should be vented prior to recompression, as well as return to diving following pulmonary barotrauma.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"345-350"},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A European code of good practice for hyperbaric oxygen therapy - Review 2022. 欧洲高压氧治疗良好操作规范--2022 年回顾。
IF 0.9 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.suppl.1-17
Jacek Kot, Jordi Desola, Folke Lind, Peter Mueller, Erik Jansen, Francois Burman, - Working Group
{"title":"A European code of good practice for hyperbaric oxygen therapy - Review 2022.","authors":"Jacek Kot, Jordi Desola, Folke Lind, Peter Mueller, Erik Jansen, Francois Burman, - Working Group","doi":"10.28920/dhm53.4.suppl.1-17","DOIUrl":"10.28920/dhm53.4.suppl.1-17","url":null,"abstract":"","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4)(Suppl","pages":"1-17"},"PeriodicalIF":0.9,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rapture of the deep: gas narcosis may impair decision-making in scuba divers. 深海狂喜:气体麻醉可能会影响水肺潜水员的决策。
IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.306-312
Pauliina A Ahti, Jan Wikgren

Introduction: While gas narcosis is familiar to most divers conducting deep (> 30 metres) dives, its effects are often considered minuscule or subtle at 30 metres. However, previous studies have shown that narcosis may affect divers at depths usually considered safe from its influence, but little knowledge exists on the effects of gas narcosis on higher cognitive functions such as decision-making in relatively shallow water at 30 metres. Impaired decision-making could be a significant safety issue for a multitasking diver.

Methods: We conducted a study exploring the effects of gas narcosis on decision-making in divers breathing compressed air underwater. The divers (n = 22) were evenly divided into 5-metre and 30-metre groups. In the water, we used underwater tablets equipped with the Iowa Gambling Task (IGT), a well-known psychological task used to evaluate impairment in decision-making.

Results: The divers at 30 metres achieved a lower score (mean 1,584.5, standard deviation 436.7) in the IGT than the divers at 5 metres (mean 2,062.5, standard deviation 584.1). Age, body mass index, gender, or the number of previous dives did not affect performance in the IGT.

Conclusions: Our results suggest that gas narcosis may affect decision-making in scuba divers at 30 metres depth. This supports previous studies showing that gas narcosis is present at relatively shallow depths and shows that it may affect higher cognitive functions.

简介:虽然气体麻醉对大多数进行深潜(大于 30 米)的潜水员来说并不陌生,但其影响在 30 米处往往被认为是微不足道或微妙的。然而,以前的研究表明,毒气麻醉可能会影响潜水员在通常被认为不受其影响的安全深度的潜水,但对于毒气麻醉对高级认知功能(如在 30 米相对较浅的水域中进行决策)的影响却知之甚少。决策能力受损可能会给多任务潜水员带来严重的安全问题:我们进行了一项研究,探讨气体麻醉对在水下呼吸压缩空气的潜水员决策的影响。潜水员(n = 22)被平均分为 5 米组和 30 米组。在水中,我们使用了配备爱荷华赌博任务(IGT)的水下平板电脑,这是一项著名的心理任务,用于评估决策障碍:结果:30 米潜水员的 IGT 得分(平均 1584.5 分,标准差 436.7 分)低于 5 米潜水员(平均 2062.5 分,标准差 584.1 分)。年龄、体重指数、性别或以前潜水的次数并不影响在 IGT 中的表现:我们的研究结果表明,毒气麻醉可能会影响水肺潜水员在 30 米深度的决策。这支持了之前的研究,这些研究表明气体麻醉在相对较浅的深度也会存在,并表明气体麻醉可能会影响较高的认知功能。
{"title":"Rapture of the deep: gas narcosis may impair decision-making in scuba divers.","authors":"Pauliina A Ahti, Jan Wikgren","doi":"10.28920/dhm53.4.306-312","DOIUrl":"10.28920/dhm53.4.306-312","url":null,"abstract":"<p><strong>Introduction: </strong>While gas narcosis is familiar to most divers conducting deep (> 30 metres) dives, its effects are often considered minuscule or subtle at 30 metres. However, previous studies have shown that narcosis may affect divers at depths usually considered safe from its influence, but little knowledge exists on the effects of gas narcosis on higher cognitive functions such as decision-making in relatively shallow water at 30 metres. Impaired decision-making could be a significant safety issue for a multitasking diver.</p><p><strong>Methods: </strong>We conducted a study exploring the effects of gas narcosis on decision-making in divers breathing compressed air underwater. The divers (n = 22) were evenly divided into 5-metre and 30-metre groups. In the water, we used underwater tablets equipped with the Iowa Gambling Task (IGT), a well-known psychological task used to evaluate impairment in decision-making.</p><p><strong>Results: </strong>The divers at 30 metres achieved a lower score (mean 1,584.5, standard deviation 436.7) in the IGT than the divers at 5 metres (mean 2,062.5, standard deviation 584.1). Age, body mass index, gender, or the number of previous dives did not affect performance in the IGT.</p><p><strong>Conclusions: </strong>Our results suggest that gas narcosis may affect decision-making in scuba divers at 30 metres depth. This supports previous studies showing that gas narcosis is present at relatively shallow depths and shows that it may affect higher cognitive functions.</p>","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 4","pages":"306-312"},"PeriodicalIF":0.8,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10944662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138801017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Within-diver variability in venous gas emboli (VGE) following repeated dives. 多次潜水后静脉气体栓塞(VGE)在潜水员内部的变化。
IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-12-20 DOI: 10.28920/dhm53.4.333-339
David J Doolette, F Gregory Murphy

Introduction: Venous gas emboli (VGE) are widely used as a surrogate endpoint instead of decompression sickness (DCS) in studies of decompression procedures. Peak post-dive VGE grades vary widely following repeated identical dives but little is known about how much of the variability in VGE grades is proportioned between-diver and within-diver.

Methods: A retrospective analysis of 834 man-dives on six dive profiles with post-dive VGE measurements was conducted under controlled laboratory conditions. Among these data, 151 divers did repeated dives on the same profile on two to nine occasions separated by at least one week (total of 693 man-dives). Data were analysed for between- and within-diver variability in peak post-dive VGE grades using mixed-effect models with diver as the random variable and associated intraclass correlation coefficients.

Results: Most divers produced a wide range of VGE grades after repeated dives on the same profile. The intraclass correlation coefficient (repeatability) was 0.33 indicating that 33% of the variability in VGE grades is between-diver variability; correspondingly, 67% of variability in VGE grades is within-diver variability. DCS cases were associated with an individual diver's highest VGE grades and not with their lower VGE grades.

Conclusions: These data demonstrate large within-diver variability in VGE grades following repeated dives on the same dive profile and suggest there is substantial within-diver variability in susceptibility to DCS. Post-dive VGE grades are not useful for evaluating decompression practice for individual divers.

简介:在减压程序研究中,静脉气体栓塞(VGE)被广泛用作减压病(DCS)的替代终点。重复相同的潜水后,潜水后 VGE 等级的峰值差异很大,但对于 VGE 等级的差异在潜水员之间和潜水员内部所占的比例却知之甚少:在受控实验室条件下,对 834 人次的六种潜水情况进行了回顾性分析,并测量了潜水后的 VGE 值。在这些数据中,有 151 名潜水员在同一剖面上进行了 2 至 9 次重复潜水,每次间隔至少一周(共计 693 人次)。采用以潜水员为随机变量的混合效应模型和相关的类内相关系数,分析了潜水员之间和潜水员内部在潜水后 VGE 等级峰值方面的差异:结果:大多数潜水员在同一剖面上重复潜水后产生的 VGE 等级差异很大。类内相关系数(可重复性)为 0.33,表明 VGE 等级中 33% 的变化是潜水员之间的变化;相应地,VGE 等级中 67% 的变化是潜水员内部的变化。DCS 病例与个体潜水员的最高 VGE 等级有关,而与较低的 VGE 等级无关:这些数据表明,在同一潜水剖面上重复潜水后,潜水员内部的 VGE 等级变化很大,并表明潜水员内部对 DCS 的易感性存在很大差异。潜水后 VGE 等级对于评估个体潜水员的减压实践并无用处。
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引用次数: 0
Diving with psychotropic medication: review of the literature and clinical considerations. 精神药物潜水:文献综述和临床注意事项。
IF 0.8 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.259-267
Abraham L Querido, Chiel F Ebbelaar, Thijs T Wingelaar

This review discusses the safety concerns associated with diving while using psychotropic medication and the limited literature available on the topic. Despite the risks, some divers continue to dive while taking these medications, and their reasons for doing so are unclear. The exact mechanisms of action of these drugs in hyperbaric environments are poorly understood. While current standards and advice for fitness-to-dive assessments are based on limited evidence and expert opinion, developing evidence-based strategies could improve patient care and optimise diving safety. This review appraises relevant literature in diving medicine and provides clinical perspectives for diving physicians conducting fitness-to-dive assessments on patients using psychotropic medication.

这篇综述讨论了在使用精神药物时与潜水相关的安全问题,以及关于该主题的有限文献。尽管存在风险,一些潜水员在服用这些药物的同时仍继续潜水,他们这样做的原因尚不清楚。这些药物在高压环境中的确切作用机制尚不清楚。虽然目前的潜水健康评估标准和建议基于有限的证据和专家意见,但制定循证策略可以改善患者护理并优化潜水安全。这篇综述评估了潜水医学的相关文献,并为潜水医生对使用精神药物的患者进行适合潜水评估提供了临床视角。
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引用次数: 0
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Diving and hyperbaric medicine
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