ALTERNATIVE MANAGEMENT OF DECOMPRESSION ILLNESS IN BREATH-HOLDING DIVERS USING NPPV
DOI:
https://doi.org/10.20961/magnaneurologica.v4i2.3315Keywords:
breath-holding diving, decompression illness, NPPVAbstract
Background: Decompression illness (DI) is a syndrome caused by the formation of gas bubbles during rapid decompression. DI can manifest with neurological manifestations. Divers are at risk of developing DI even in shallow water.
Case: A 25-year-old woman lost consciousness after a training dive. She lost consciousness shortly after surfacing, having previously dived to a depth of four meters. She vomited once and denied seizures. This was her third training dive; the second occurred two days prior, and the first ten days prior. The patient was in good health and had no history of heart or lung problems. A non-contrast head CT scan and MRI revealed ischemic lesions in the bilateral thalamus and cerebellum. Chest X-ray (CXR), transthoracic echocardiography (TTE), echocardiography, and bubble contrast scans showed no abnormalities. The patient was treated with 100% oxygen via non-invasive positive pressure ventilation (NPPV – CPAP mode) and showed improvement in her neurological deficits after 10 days.
Discussion: DI is associated with vascular or extravascular bubbles that form as a result of rapid decompression. Pure oxygen inhalation using HBOT is the main therapy for DI. But, in the absence of HBOT, NPPV can be considered for its effectiveness to achieve a mean arterial pO2 concentration above 500 mm Hg.
Conclusion: Recognizing the signs and symptoms of DI is important because they are nonspecific. Oxygen: 100% oxygen should be administered to those suspected of having DI.
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