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Number 4

Performance of life support breathing apparatus for under-ice diving operations

Introduction: Single-hose scuba regulators dived in very cold water may suffer first- or second-stage malfunction, yielding complete occlusion of air flow or massive freeflow that rapidly expends a diver’s air supply. Purpose: This study, conducted in Antarctica, evaluated the under-ice performance of a sampling of commercially available regulators. Methods: Seventeen science divers logged a total of 305 dives in -1.86°C seawater under 6-meter-thick Antarctic fast-ice over two field seasons in 2008 and 2009. Dive profiles had an average depth of 30 msw and dive time of 29 minutes, including a mandatory three-minute safety stop at 6 msw. Sixty-nine unmodified regulator units (17 models) from ..


Cerebrospinal vascular diseases misdiagnosed as decompression illness: the importance of considering other neurological diagnoses

The diagnosis of decompression illness (DCI), which is based on a history of decompression and clinical findings, can sometimes be confounded with other vascular events of the central nervous system. The authors report three cases of divers who were urgently transported to a hyperbaric facility for hyperbaric oxygen treatment of DCI which at admission turned out to be something else.  The first case, a 45-year-old experienced diver with unconsciousness, was clinically diagnosed as having experienced subarachnoid hemorrhage, which was confirmed by CT scan. The second case, a 49-year-old fisherman with a hemiparesis which occurred during diving, was diagnosed as cerebral stroke, ..


Hyperbaric oxygen therapy for wound breakdown after oronasal fistula and cleft palate repair: four cases

We offer the first report of hyperbaric oxygen (HBO2) therapy to treat early surgical wound breakdown after oronasal fistula and cleft palate repair in the pediatric population. We present four patients’ experiences after undergoing HBO2 therapy. HBO2 was initiated as soon as an oronasal fistula was identified. Three of the children underwent 10 HBO2 treatments with the fourth undergoing 11 treatments. There were no adverse effects during treatment; none of the patients required decompressive myringotomy. Follow-up shows portions of the repair have been salvaged by initiating HBO2 at the first sign of fistula formation. In our case series, the fistulas ..


Attenuation of collagen-induced arthritis by hyperbaric oxygen therapy through altering immune balance in favor of regulatory T cells

Hyperbaric oxygen (HBO2) therapy is currently used for the treatment of chronic wounds, radiation-induced soft tissue necrosis, several oxygen-deficiency conditions and decompression sickness. In addition to the current indications, much empirical and experimental data suggest that HBO2 therapy may benefit autoimmune diseases by suppressing immunity, but the underlying mechanism is not well understood.  Therefore, in the present study, we investigated whether HBO2 prevents the development of collagen-induced arthritis (CIA) in association with alteration of the immune balance between pro-inflammatory Th17 and anti-inflammatory regulatory T cells (Tregs). Arthritis was induced in DBA/1 mice by intradermal injection of type II collagen. Animals received either no treatment or ..


Comparison of normobaric vs. hyperbaric oxygen in the relief of carbon monoxide headache pain

Background: Headache is the most common symptom in carbon monoxide (CO) poisoning. While the mechanism of CO-induced headache is not well defined, it is felt that cerebral vasodilation plays a role. Clinical experience has demonstrated oxygen breathing is effective in resolving CO headache. However, the effectiveness of normobaric oxygen has never been compared to hyperbaric oxygen in this regard. Methods: A 2016 paper by Ocak, et al. reported the response of CO headache pain severity to four hours of normobaric oxygen breathing in 82 patients using a 0-10 analog scale. The demographics, carboxyhemoglobin levels and response to therapy from that report ..


Reduction of side effects of hyperbaric oxygen therapy with thymoquinone treatment in rats

Introduction: Hyperbaric oxygen (HBO2) treatment results in elevated production of reactive oxygen species (ROS) that leads to cellular damage. Thymoquinone (TQ) is reported to have anti-inflammatory and anti-microbial activity and may suppress the generation of free radicals. The goal of this study is reduction of side effects of hyperbaric oxygen therapy with thymoquinone treatment. Methods: 30 female Sprague-Dawley rats were randomly assigned to one of three groups (n = 10 per group). Group 1 represented the control group (no treatment). Group 2 was exposed to 100% oxygen at 2.5 ATA for two sessions of two hours’ duration each day for five days. Group 3 was ..


Hyperbaric oxygen therapy for five days increases blood-brain barrier permeability

This study aimed to explore the effects of hyperbaric oxygen (HBO2) on blood-brain barrier (BBB) integrity in rats, when administered for one (at 2.5 ATA, 3 HBO2 sessions a day) and five days (at 2.5 ATA, 3 HBO2 sessions a day for the first two days, and twice a day for the last three days). Horseradish peroxidase (HRP) was used to evaluate the BBB permeability. Superoxide dismutase (SOD) activity, glutathione (GSH) andmalondialdehyde (MDA) levels were measured in the cerebral cortex and hippocampus regions. Frequent vesicles containing HRP reaction products were observed in capillary endothelial cells in the cerebral cortex and hippocampus of rats subjected to ..


Effect of hyperbaric oxygen therapy on complete blood count

Complete blood count (CBC) is a routine diagnostic procedure for patients and a part of routine health inspection for healthy individuals. The effect of hyperbaric oxygen (HBO2) therapy on CBC is not known. The objective of this study was to determine the effects of HBO2 on blood parameters in CBC with long-term HBO2 therapy. In this study, patients received HBO2 at the department of Underwater and Hyperbaric Clinical Medicine. CBC results were obtained at specific time points during HBO2 therapy. The study recruited a total of 140 patients who met the research inclusion criteria. Patients were treated for 55.5±41 days. During the treatment period, ..


Delayed treatment of frostbite with hyperbaric oxygen: a report of two cases

Frostbite is an injury caused by the freezing of tissue, causing varied levels of tissue damage and necrosis. Case reports have shown a positive effect of hyperbaric oxygen (HBO2) in such injuries, in acute cases as well as delayed (up to 21 days) presentation with complications. In this case report we present the course of hyperbaric treatment of two patients (a brother and sister, age 58 and 62) who sustained frostbite injuries to both feet 28 days earlier while hiking in the Himalayas. They were initially treated in Nepal following local protocol; afterward their primary care in the Netherlands was ..