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Number 1

UHM Journal Number 44-1 - Jan-Feb 2017 - full issue

  02-06-2017

INTRODUCTION - Hyperbaric medicine today: an historically noble discipline challenged by loss of critical access and overutilization

The field of undersea and hyperbaric medicine has changed since the day six Naval officers established the Undersea Medical Society in 1967. At that time, the focus of the field primarily involved the treatment of emergencies, but over the next 50 years, the UHMS has promulgated the use of hyperbaric oxygen (HBO2) therapy for many additional indications. The field of hyperbaric medicine has grown to include more than the treatment of emergent indications, and as the interest in using HBO2 for non-healing wounds increased, the number of facilities available for emergency and critical care hyperbaric oxygen therapy has dropped. ..

  02-06-2017

INVITED COMMENTARY - Hyperbaric medicine today: an historically noble discipline challenged by loss of critical access and overutilization

As the title implies, much appears amiss with hyperbaric medicine. Long recognized for its life-saving, CNS-sparing, infection fighting and tissue-salving attributes, its current application has been rightly called into question by a broad cross-section of health care delivery system stakeholders [1, 2, 3, 4, 5]. This paper will examine what lies behind the stunning loss of availability for a majority of the Federal Drug Administration-approved uses, arguably those for which patients have the most to gain. It will address overutilization in the context of an erosion of practice standards and widespread manipulation of the reimbursement process. It will make ..

  02-06-2017

Garage carbon monoxide levels from sources commonly used in intentional poisoning

Background: The incidence of intentional carbon monoxide (CO) poisoning is believed to have declined due to strict federal CO emissions standards for motor vehicles and the uniform application of catalytic converters (CC). We sought to compare ambient CO levels produced by automobiles with and without catalytic converters in a residential garage, as well as from other CO sources commonly used for intentional poisoning. Methods: CO levels were measured inside a free-standing 73 m3 one-car garage. CO sources included a 1971 automobile without CC, 2003 automobile with CC, charcoal grill, electrical generator, lawn mower and leaf blower. Results: After 20 minutes of ..

  02-06-2017

Evaluation of the Carefusion Alaris PC infusion pump for hyperbaric oxygen therapy conditions: Technical report

We present a standardized test methodology and results for our evaluation of the Carefusion Alaris PC infusion pump, comprising the model 8015 PC Unit and the model 8100 Large Volume Pump (LVP) module. The evaluation consisted of basic suitability testing, internal component inspection, surface temperature measurement of selected internal components, and critical performance testing (infusion rate accuracy and occlusion alarm pressure) during conditions of typical hyperbaric oxygen (HBO2) treatment in our facility’s class A multiplace chamber. We have found that the pumps pose no enhanced risk as an ignition source, and that the pumps operate within manufacturer’s specifications for flow rate ..

  02-06-2017

Test results for the evaluation of a glucometer for use under hyperbaric conditions: Technical report

This study aimed to evaluate a recently developed equipment test method by assessing the safe and accurate functioning of the Abbott Optium FreeStyle H portable blood glucose monitor for use in the Alfred Hospital’s hyperbaric chamber. The results of this study indicate that the test method can be used successfully to evaluate instruments and/or devices for use in the hyperbaric environment. The evaluation initially found that this particular glucose monitor contained a lithium battery that can be hazardous when used in the hyperbaric environment. However, upon further inspection it was determined the battery posed minimal risk for fire and explosion ..

  02-06-2017

Oridonin protects the lung against hyperoxia-induced injury in a mouse model

Hyperoxic acute lung injury (HALI) is caused by prolonged exposure to high oxygen partial pressure. This study was undertaken to investigate the protective effects of oridonin on HALI in a mouse model. Mice were randomly divided into three groups: the control group, HALI group and oridonin (ORI) group. HALI was induced by exposing mice to pure oxygen at 2.5 atmospheres absolute (ATA) for six hours in the HALI and ORI groups. In the ORI group, mice were intraperitoneally injected with ORI at 10 mg/kg twice daily after hyperoxic exposure. Animals were sacrificed 24 hours after the hyperoxia exposure, followed by bronchoalveolar ..

  02-06-2017

Changes in angiotensin II and angiotensin-converting enzyme of different tissues after prolonged hyperoxia exposure

Current study findings concerning changes in the renin-angiotensin system (RAS) in cases of hyperoxic acute lung injury (HALI) have shown conflicting results. This study aimed to detect the angiotensin II (Ang II) and angiotensin-converting enzyme (ACE) in a rat HALI model. Healthy male Sprague-Dawley rats were randomly assigned into three groups: the control group, HALI group and hyperbaric oxygen preconditioning (HBO2-PC) group. HALI was induced by exposure to pure oxygen at 250 kPa for six hours. In the HBO2-PC group, rats were exposed to oxygen at 250 kPa for 60 minutes twice daily for two consecutive days; HALI was induced ..

  02-06-2017

Scuba in older-aged divers

As the population gets older, coupled with increased awareness of good health practices and the recognition that fitness contributes to participation in activities generally appropriate for younger individuals, decisions need to be made about what are appropriate activities for the older-aged scuba (self-contained underwater breathing apparatus) diver. It is essential to appreciate the distinction between chronological and physiological age. Three factors, namely fitness, comorbidities, and mobility and strength are fundamental when making decisions about participation in activities in general as well as in scuba diving for older adults. There is almost always a time to “call it quits” for everything. DOI: 10.22462/1.2.2017.8

  02-06-2017

Relationship between clinical and radiologic findings of spinal cord injury in decompression sickness

Background: Decompression sickness may involve the central nervous system. The most common site is spinal cord. This study was conducted to determine the relationship between magnetic resonance(MR) imaging findings of spinal damage and clinical findings in acute decompression sickness. Methods: We conducted a retrospective review of 12 patients (male=10, female=2) who presented with spinal cord symptoms. We investigated their clinical features, neurological findings and radiologic findings. Results: The depth and bottom time of the dive were 34.5 meters (range 22-56) and 22.7 minutes (range 10-55) respectively. Most divers ascended within appropriate time frame as shown by the decompression tables. The most ..

  02-06-2017

Adjunctive hyperbaric oxygen treatment for idiopathic sudden sensorineural hearing loss

Introduction: This study aims to evaluate the hearing gain efficacy from adjunctive hyperbaric oxygen (HBO2) treatment in patients with idiopathic sudden sensorineural hearing loss (ISSHL). Materials and Methods: A retrospective analysis of chart reviews was performed on patients with ISSHL between January 2013 through December 2015. All patients were referred to us from our ENT Department for adjunctive hyperbaric oxygen treatment. The results were assessed through pure-tone audiometry (PTA) data change (hearing gain), both before and after HBO2 treatment. Age, gender, affected ear side, HBO2 treatment sessions, both before and after HBO2 treatment PTA were all recorded. Results: Ninety-three (93) patients ..

  02-06-2017

Non-dysbaric arterial gas embolism associated with chronic necrotizing pneumonia, bullae and coughing: a case report

Arterial gas embolism (AGE) can be clinically devastating, and is most often associated with exposure to changes in ambient pressure, medical procedure or congenital malformation. Here we report a case of AGE in a 78-year-old male without these traditional risk factors. Rather, the patient’s history included chronic obstructive pulmonary disease, necrotizing pneumonia, bullous disease and coughing. He was safely treated with hyperbaric oxygen (HBO2) therapy for AGE, with initial clinical improvement, but ultimately died from his underlying condition. Pathophysiology is discussed. This case illustrates the possibility that AGE can occur due to rupture of lung tissue in the absence ..

  02-06-2017

Bebe Vio: On top of the world - Letter

I do not think we will forget the joy we felt when Beatrice Bebe Vio won the Paralympic Gold in Rio in 2016 for fencing with foil. Nor can we forget the famous selfie taken by President Obama with her during his last official State Dinner in October 2016 while he entertained the Italian delegation. It is certain that Bebe will remember this year as a special time full of emotions that only very few people in the world can experience . . . DOI: 10.22462/1.2.2017.11

  02-06-2017

Erratum regarding inaccurate authorship attributions noted

  02-06-2017

IPE, SDPE, PESD: What’s in a name? Letter

I was quite entertained to read the clashing commentaries by Dr. Mike Davis [1] and Dr. Carl Edmonds [2] regarding immersion pulmonary edema (IPE). Much of their disagreement centers on nomenclature for the condition and whether IPE warrants splitting into “scuba divers pulmonary edema” (SDPE) and “swimming-induced pulmonary edema” (SIPE). DOI: 10.22462/1.2.2017.12

  02-06-2017

TBI study questioned: Dr. Gottlieb - Letter

I was pleased, surprised and upset that a special issue of the (UHM) Journal (Vol 43, No 5, 2016) was devoted to one study concerning the role of HBO2 in treating TBI . . . DOI: 10.22462/1.2.2017.13

  02-06-2017

TBI study questioned: Dr. Weaver response - Letter

  02-06-2017

TBI study questioned: Dr. Gottlieb’s response to Dr. Weaver and Editor's note

  02-06-2017

MEDFAQS - maintenance records and no-go lists

  02-06-2017

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