Definition and Causes

Decompression sickness (DCS) is the release of gas bubbles into the blood caused by a sudden decrease in pressure around the body. Commonly called the bends, and sometimes diver’s disease or caisson disease, DCS most notably afflicts SCUBA divers.
Oxygen and nitrogen bubbles form in the organs and tissues during a long or deep dive.
Nitrogen bubbles enter the bloodstream when a diver ascends too rapidly.
Flying in an unpressurized airplane may also cause DCS.

Decompression sickness is the most common cause of air or gas embolism.

An embolism is a blockage in the bloodstream. A bubble can obstruct blood flow and damage the brain, the heart, or other vital organs and tissues, resulting in pain or death.

Permanent disabilities may include vision impairment, paralysis, and respiratory problems.

The diagnosis of DCS is made on the basis of signs and/or symptoms after a dive or altitude exposure.

Manifestations most commonly include paresthesias, hypesthesia, joint pain, skin rash and malaise.

More serious signs and symptoms include motor weakness, ataxia, dyspnea, urethral and anal sphincter dysfunction, shock and death.

Severe DCS may be accompanied by hemoconcentration and hypotension.

Severe symptoms usually occur within 1-3 hours of decompression; the vast majority of all symptoms manifest within 24 hours, unless there is an additional decompression (e.g. altitude exposure).

More serious signs and symptoms include motor weakness, ataxia, dyspnea, urethral and anal sphincter dysfunction, shock and death.

Severe DCS may be accompanied by hemoconcentration and hypotension.

Severe symptoms usually occur within 1-3 hours of decompression; the vast majority of all symptoms manifest within 24 hours, unless there is an additional decompression (e.g. altitude exposure).

Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) in a recompression chamber is the primary treatment for decompression sickness. Increased atmospheric pressure reduces the size of nitrogen bubbles and helps them dissolve into the bloodstream. Oxygen-supersaturated blood displaces nitrogen and reaches deep into oxygen-deprived tissues.


Undersea and Hyperbaric Medical Society

Mechanisms of HBO2

Improvement of decompression sickness symptoms as a result of compression was first noted in the nineteenth century.(24) Recompression with air was first reported as a specific treatment for that purpose in 1896.

Oxygen breathing was observed to improve the signs of decompression sickness in animals.

The use of oxygen with pressure to accelerate gas diffusion and bubble resolution in humans was first suggested in 1897 and eventually tested in human DCS and recommended for the treatment of divers in the 1930's.

The rationale for treatment with hyperbaric oxygen (HBO2) includes immediate reduction in bubble volume, increasing the diffusion gradient for inert gas from the bubble into the surrounding tissue, oxygenation of ischemic tissue and reduction of CNS edema. It is also likely that HBO2 has other beneficial pharmacological effects, such as a reduction in neutrophil adhesion to the capillary endothelium.

The efficacy of administration of oxygen at increased ambient pressure (hyperbaric oxygen, HBO2) is widely accepted, and HBO2 is the mainstay of treatment for this disease.

Air or Gas Embolism

Definition and Causes

An embolism is a moving obstruction in the bloodstream. An air or gas bubble can obstruct blood flow and damage the brain, the heart, or other vital organs and tissues, resulting in pain or death. Permanent disabilities may include vision impairment, p aralysis, and respiratory problems.

Gas bubbles in veins travel to the heart and then to the lungs. If the bubbles are small, such as those introduced inadvertently through intraveneous fluid lines, they are usualy stopped at the lungs and rarely produce symptoms. Larger gas bubbles in veins can lodge in the heart, lungs, or brain and cause damage.

Arterial gas embolisms (AGE) can be much more damaging because they can directly obstruct the flow of blood to body tissue. Even small arterial gas obstructions can cause death by stopping the flow of blood to the heart, brain, and lungs.

Rapid decompression events, such as scuba diving accidents, can cause gas embolisms through the formation of bubbles from the release of dissolved nitrogen in the body. Nitrogen bubbles can form directly in tissue and cause damage there.

Nitrogen bubbles can also form in the circulatory system from gas disolved in blood. But because arterial blood has recently passed through the lungs, where excess gas can be released, gas embolisms usually do not form in arteries from decompression events.

Air or gas embolisms can also result from mechanisms of injury that have nothing to do with decompression, such as industrial accidents involving compressed air or gas. Some medical procedures carry an increased risk of introducing gas bubbles into the bloodstream, although the occurence of such injuries is rare.

Treatment with Hyperbaric Oxygen Therapy

Hyperbaric oxygen therapy (HBOT) in a recompression chamber is the primary treatment for air or gas embolism. Increased atmospheric pressure reduces the size of bubbles and helps them dissolve into the bloodstream. Oxygen-supersaturated blood displaces nitrogen bubbles and reaches deep into oxygen-deprived tissues.

 

Send your comments and questions by filling out the form.

We will reply as quickly as possible

Please Share

Your message was successfully sent!

Contact Information

Pellapais 2

2057 Strovolos

22357580

Dr S Georghiou   99650811
Dr S Koumas   99626492

 

Βρείτε μας εδώ