10,824 results match your criteria Dysbarism

High Peak Inspiratory Pressures After a Change of Heat and Moisture Exchangers: A Case Series.

A A Pract 2021 Jun 10;15(6):e01483. Epub 2021 Jun 10.

From the Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Elevated peak inspiratory pressures (PIPs) cause harm via hypoventilation, barotrauma, and hemodynamic instability. Heat and moisture exchangers (HMEs) are used during mechanical ventilation to prevent heat loss, dehydration of airway mucosa, and accumulation of dried secretions. Multiple reports detail sudden HME occlusions causing increased PIPs. Read More

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Incidence of pneumomediastinum in COVID-19: A single-center comparison between 1st and 2nd wave.

Respir Investig 2021 May 28. Epub 2021 May 28.

Tor Vergata Polyclinic, Department of Surgery, Units of Thoracic Surgery and Breast Surgery, Floor 7A, Viale Oxford 81, 00133, Rome, Italy.

In this study, we compared the incidence of pneumomediastinum in coronavirus disease (COVID-19) patients during the ascending phases of the 1st and 2nd epidemic waves. Crude incidence was higher during the 2nd wave at a quasi-significant level (0.68/1000 vs. Read More

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Awake Extracorporeal Membrane Oxygenation in Coronavirus Disease 2019 Patients Without Invasive Mechanical Ventilation.

Crit Care Explor 2021 Jun 3;3(6):e0454. Epub 2021 Jun 3.

Department of Adult Intensive Care Unit, Fakeeh Care Group, Jeddah, Saudi Arabia.

Objectives/background: Extracorporeal membrane oxygenation is used as rescue therapy for patients with acute respiratory distress syndrome in whom conventional therapy has failed prior to an Extra Corporeal Membrane Oxygenator to rescue Lung Injury in Severe Acute Respiratory Distress Syndrome trial. Since then, extracorporeal membrane oxygenation has been incorporated as part of the standard treatment algorithm in many centers for patients with severe acute respiratory distress syndrome. Since the emergence of coronavirus disease 2019 in early 2020, extracorporeal membrane oxygenation has been used effectively as rescue therapy and as a bridge to recovery in some patients with refractory respiratory failure. Read More

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Inner Ear Disorders in SCUBA Divers: A Review.

J Int Adv Otol 2021 May;17(3):260-264

Department of Surgical Sciences, University of Turin, Turin, Italy.

Self-Contained Underwater Breathing Apparatus (SCUBA) diving is a popular sport. However, improper diving may injure different organs. The majority of dive-related disorders concern otolaryngology, and may include hearing loss, tinnitus, aural fullness, disequilibrium, and vertigo. Read More

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Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of Simulation as a Learning Technique.

Front Physiol 2021 21;12:666503. Epub 2021 May 21.

Environmental and Respiratory Physiology Laboratory and Master Level II in Diving and Hyperbaric Medicine, Department of Biomedical Sciences, University of Padova, Padua, Italy.

Introduction: Hyperbaric chambers and underwater environments are challenging and at risk of serious accidents. Personnel aiming to assist patients and subjects should be appropriately trained, and several courses have been established all over the world. In healthcare, simulation is an effective learning technique. Read More

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Breath-Hold Diving - The Physiology of Diving Deep and Returning.

Front Physiol 2021 21;12:639377. Epub 2021 May 21.

Center for Heart, Lung & Vascular Health, University of British Columbia Okanagan, Kelowna, BC, Canada.

Breath-hold diving involves highly integrative physiology and extreme responses to both exercise and asphyxia during progressive elevations in hydrostatic pressure. With astonishing depth records exceeding 100 m, and up to 214 m on a single breath, the human capacity for deep breath-hold diving continues to refute expectations. The physiological challenges and responses occurring during a deep dive highlight the coordinated interplay of oxygen conservation, exercise economy, and hyperbaric management. Read More

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[What is the Best Therapeutic Strategy for Decompression Illness? First Aid Oxygen Inhalation and Hyperbaric Oxygen Therapy].

J UOEH 2021 ;43(2):243-254

Department of Environmental Medicine, Kurume University School of Medicine.

Decompression illness (DCI), a syndrome following inadequate reduction in environmental pressure, has two forms: decompression sickness and arterial gas embolism after pulmonary barotrauma. Recompression therapy using oxygen, a kind of hyperbaric oxygen therapy, has been considered the gold standard treatment for DCI, although there is no randomized controlled trial evidence for its use. We evaluated the effectiveness of recompression therapy in treating DCI by reviewing the reported therapeutic results of serious DCI, especially neurological disorders. Read More

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January 2021

The incidence, clinical characteristics, and outcomes of pneumothorax in hospitalized COVID-19 patients: A systematic review.

Heart Lung 2021 May 1;50(5):599-608. Epub 2021 May 1.

Department of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, NY, United States.

Background: Pneumothorax has been frequently described as a complication of COVID-19 infections.

Objective: In this systematic review, we describe the incidence, clinical characteristics, and outcomes of COVID-19-related pneumothorax.

Methods: Studies were identified through MEDLINE, Pubmed, and Google Scholar databases using keywords of "COVID-19," "SARS-CoV-2," "pneumothorax," "pneumomediastinum," and "barotrauma" from January 1st, 2020 to January 30th, 2021. Read More

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Pulmonary Barotrauma in COVID-19 Patients: Invasive versus Noninvasive Positive Pressure Ventilation.

Int J Gen Med 2021 24;14:2017-2032. Epub 2021 May 24.

Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, 22110, Jordan.

Purpose: This study aims to determine the incidence and outcome of COVID-19 patients who required positive pressure ventilation (PPV) and subsequently developed pulmonary barotrauma (PBT). Also, to investigate the risk factors and predictors of these complications to better understand the disease pathogenesis.

Patients And Methods: This retrospective analysis enrolled all adult COVID-19 patients admitted through the period from October 1, 2020, to December 31, 2020. Read More

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[A case of decompression sickness complicated with multiple organ failure treated by hyperbaric oxygen therapy sequential with continuous renal replacement therapy and extracorporeal membrane oxygenation].

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021 May;39(5):368-371

Department of Hyperbaric Oxygen, General Hospital of Eastern War Zone, Nanjing 210002, China.

To discuss the new idea of on-the-spot recompression treatment and multidisciplinary treatment (MDT) for patients with unstable vital signs of type II decompression sickness. To provide reference for the nearby treatment of patients with critical decompression sickness. The clinical data of a case of a multi-disciplinary collaborative treatment of type II decompression sickness complicated with multiple organ dysfunction syndrome (MODS) admitted to a third-class A hospital in January 2020 were analyzed and summarized. Read More

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Covid-19 Pneumonia and Ventilation-induced Lung Injury: A Case Report.

Rom J Anaesth Intensive Care 2020 Dec 31;27(2):80-82. Epub 2020 Dec 31.

Intensive Care department, Maasstad Ziekenhuis, Rotterdam, The Netherlands.

We present the case of a 67-year-old male patient, who was admitted to the intensive care unit for hypoxemic respiratory failure due to severe COVID-19 pneumonitis, requiring mechanical ventilation. Despite close monitoring using transpulmonary pressure measurements and interventions to pursue lung-protective ventilation, the patient developed extensive barotrauma including a right-sided pneumothorax, subcutaneous emphysema and pneumomediastinum while on pressure support ventilation. We hypothesize that the high respiratory drive that COVID-19 patients seem to exhibit, combined with diffuse alveolar injury and increased alveolar pressure, resulted in gross barotrauma. Read More

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December 2020

Pneumothorax in critically ill patients with COVID-19 infection: Incidence, clinical characteristics and outcomes in a case control multicenter study.

Respir Med 2021 May 13;184:106464. Epub 2021 May 13.

Department of Medicine, Pulmonary and Critical Care Medicine, Albany Medical Center, NY, USA.

Background: The clinical features and outcomes of mechanically ventilated patients with COVID-19 infection who develop a pneumothorax has not been rigorously described or compared to those who do not develop a pneumothorax.

Purpose: To determine the incidence, clinical characteristics, and outcomes of critically ill patients with COVID-19 infection who developed pneumothorax. In addition, we compared the clinical characteristics and outcomes of mechanically ventilated patients who developed a pneumothorax with those who did not develop a pneumothorax. Read More

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Treatment of Bronchopleural and Alveolopleural Fistulas in Acute Respiratory Distress Syndrome With Extracorporeal Membrane Oxygenation, a Case Series and Literature Review.

Crit Care Explor 2021 May 14;3(5):e0393. Epub 2021 May 14.

Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego, La Jolla, CA.

Objectives: To describe a ventilator and extracorporeal membrane oxygenation management strategy for patients with acute respiratory distress syndrome complicated by bronchopleural and alveolopleural fistula with air leaks.

Design Setting And Participants: Case series from 2019 to 2020. Single tertiary referral center-University of California, San Diego. Read More

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Barotrauma Linked to Coronavirus Disease 2019 Infection in Younger Patients: A Case Series.

Cureus 2021 Apr 20;13(4):e14573. Epub 2021 Apr 20.

Pulmonary Critical Care Medicine, Rutgers University, Newark, USA.

Patients infected with coronavirus disease 2019 (COVID-19) on invasive mechanical ventilation were found to have high rates of barotrauma. Herein, we present five patients admitted to the intensive care unit between March and April 2020, who developed barotrauma as a complication of COVID-19 pneumonia. This series includes four males and one female with a mean age of 54 years, most without significant chronic comorbidities or former tobacco use. Read More

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Minimally invasive surfactant therapy intubation for surfactant delivery in preterm infant with RDS: evaluation of safety and efficacy.

J Matern Fetal Neonatal Med 2021 May 23:1-5. Epub 2021 May 23.

Department of Neonatology, Ziv Medical Center, Tsfat, Israel.

Background: Minimally invasive surfactant therapy (MIST) is a promising mode of administration that offers the potential to limit barotrauma and prevent lung injury in preterm infants with respiratory distress syndrome (RDS).

Objective: This study assessed the effects of the implementation of MIST on safety and efficacy in infants who met criteria for surfactant administration and were treated by MIST as compared with a historical control group treated with surfactant an endotracheal tube during mechanical ventilation.

Methods: This retrospective study included infants born between 2012 and 2017 who met the following inclusion criteria: gestational age 23-36 + 6 weeks, a diagnosis of RDS requiring at least 30% oxygen with or without nasal continuous positive airway pressure (nCPAP). Read More

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Treatment of Peripheral Nerve Injuries in Syria's War Victims: Experience from a Northern Israeli Hospital.

Isr Med Assoc J 2021 May;23(5):279-285

Department of Orthopedic Surgery and Traumatology, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.

Background: The collapse of the Syrian healthcare system during the civil war led numerous citizens to cross the Syrian-Israeli border to seek medical care.

Objectives: To describe the epidemiology of peripheral nerve injuries (PNIs) sustained in war, their management, and short-term outcomes.

Methods: A retrospective case series study was conducted on 45 consecutive patients aged 25. Read More

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Pneumomediastinum in COVID-19: A series of three cases and review of literature.

SAGE Open Med Case Rep 2021 29;9:2050313X211011807. Epub 2021 Apr 29.

Department of Radiology, Apollo Hospitals, Chennai, India.

Coronavirus disease-19 caused by severe acute respiratory syndrome Corona virus-2 is characterised by wide heterogeneity in clinical presentation. The typical radiographic findings in COVID-19 include bilateral ground-glass opacities and/or consolidations predominantly affecting the lower lobes and posterior segments of lungs. Other rare abnormal radiographic findings include pneumothorax, pneumomediastinum and pneumopericardium. Read More

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Pulmonary Barotrauma in COVID-19 Patients With ARDS on Invasive and Non-Invasive Positive Pressure Ventilation.

J Intensive Care Med 2021 May 20:8850666211019719. Epub 2021 May 20.

Pulmonary, Critical Care & Sleep Medicine, 12284University of Nebraska Medical Center, Omaha, NE, USA.

Background: We experienced a high incidence of pulmonary barotrauma among patients with coronavirus disease-2019 (COVID-19) associated acute respiratory distress syndrome (ARDS) at our institution. In current study, we sought to evaluate the incidence, clinical outcomes, and characteristics of barotrauma among COVID-19 patients receiving invasive and non-invasive positive pressure ventilation.

Methodology: This retrospective cohort study included adult patients diagnosed with COVID-19 pneumonia and requiring oxygen support or positive airway pressure for ARDS who presented to our tertiary-care center from March through November, 2020. Read More

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Case Report: Barotrauma in COVID-19 Case Series.

Am J Trop Med Hyg 2021 May 18. Epub 2021 May 18.

2Isfahan University of Medical Science, Isfahan, Iran.

Severe acute respiratory syndrome coronavirus 2 can cause pulmonary complications, such as increased risk of barotrauma (BT), but its prevalence and risk factors are not known. In this case series, the course of BT and its related risk factors were discussed in patients with COVID-19 who were admitted to the intensive care unit. Medical records of the patients with COVID-19 and BT and hospitalized in the intensive care unit for 5 months were extracted. Read More

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Hyperbaric oxygen for decompression sickness.

Undersea Hyperb Med 2021 Second Quarter;48(2):195-203

Departments of Anesthesiology and Medicine, Center for Hyperbaric Medicine and Environmental Physiology, Duke University, North Carolina U.S.

Decompression sickness (DCS, "bends") is caused by formation of bubbles in tissues and/or blood when the sum of dissolved gas pressures exceeds ambient pressure (supersaturation). This may occur when ambient pressure is reduced during any of the following: ascent from a dive; depressurization of a hyperbaric chamber; rapid ascent to altitude in an unpressurized aircraft or hypobaric chamber; loss of cabin pressure in an aircraft; and during space walks. Read More

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Prevention of middle ear barotrauma with oxymetazoline/fluticasone treatment.

Undersea Hyperb Med 2021 Second Quarter;48(2):149-152

University of Florida, Department of Anesthesiology, Gainesville, Florida U.S.

Middle ear barotrauma (MEB) is a common complication of hyperbaric oxygen (HBO2) therapy. It has been reported in more than 40% of HBO2 treatments and can interrupt the sequence of HBO2. MEB may lead to pain, tympanic membrane rupture, and even hearing loss. Read More

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Acclimatization to diving: a systematic review.

Jan Risberg

Undersea Hyperb Med 2021 Second Quarter;48(2):127-147

Office of Submarine and Diving Medicine, Norwegian Armed Forces Joint Medical Services.

Multiday hyperbaric exposure has been shown to reduce the incidence of decompression sickness (DCS) of compressed-air workers. This effect, termed acclimatization, has been addressed in a number of studies, but no comprehensive review has been published. This systematic review reports the findings of a literature search. Read More

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Variability in venous gas emboli following the same dive at 3,658 meters.

Undersea Hyperb Med 2021 Second Quarter;48(2):119-126

University at Buffalo, Department of Exercise and Nutrition Sciences, Center for Research and Education in Special Environments, Buffalo, New York U.S.

Exposure to a reduction in ambient pressure such as in high-altitude climbing, flying in aircrafts, and decompression from underwater diving results in circulating vascular gas bubbles (i.e., venous gas emboli [VGE]). Read More

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Cocaine-Induced Bronchial Laceration: A Rare Incidence.

Cureus 2021 Apr 1;13(4):e14252. Epub 2021 Apr 1.

Internal Medicine, Corpus Christi Medical Center, Corpus Christi, USA.

Tracheobronchial injuries are either traumatic or iatrogenic but can be lethal in a high dependency setting if not managed promptly. There are few reported cases of cocaine-induced airway damage and barotrauma due to thermal or ischemic injury and increased intra-alveolar pressure. We present a sui generis case of cocaine-induced bronchial laceration with pneumomediastinum which was challenging to diagnose based on the patient's recent history of hospitalization, as well as the patient's reluctance to share the history of cocaine use. Read More

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Pneumothorax and pneumomediastinum in COVID-19 acute respiratory distress syndrome.

Monaldi Arch Chest Dis 2021 Apr 16;91(2). Epub 2021 Apr 16.

Department of Anesthesiology and Perioperative Medicine, Division of Critical Care, Mayo Clinic, Rochester, MN.

COVID-19 has involved numerous countries across the globe and the disease burden, susceptible age group; mortality rate has been variable depending on the demographical profile, economic status, and health care infrastructure. In the current clinical environment, COVID-19 is one of the most important clinical differential diagnoses in patients presenting with respiratory symptoms. The optimal mechanical ventilation strategy for these patients has been a constant topic of discussion and very importantly so, since a great majority of these patients require invasive mechanical ventilation and often for an extended period of time. Read More

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Pneumomediastinum, Pneumoretroperitoneum, Pneumoperitoneum and Subcutaneous Emphysema Secondary to a Penetrating Anal Injury.

Diagnostics (Basel) 2021 Apr 15;11(4). Epub 2021 Apr 15.

Department of Emergency Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 600, Taiwan.

Simultaneous occurrence of pneumoperitoneum, pneumoretroperitoneum, pneumomediastinum and subcutaneous emphysema is rare. The most reported mechanisms are barotrauma, thermal injury and instrument puncture caused by colonoscopy. Ectopic air may travel into different body compartments through distinct anatomical fascial planes. Read More

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Effect of self-acupressure on middle ear barotrauma associated with hyperbaric oxygen therapy: A nonrandomized clinical trial.

Medicine (Baltimore) 2021 Apr;100(17):e25674

Department of Chinese Medicine, Kaohsiung.

Background: In hyperbaric oxygen therapy (HBOT), a patient is exposed to pure oxygen in a chamber. While HBOT is a long-standing and well-established treatment for a wide variety of medical conditions, one of the main complications is middle ear barotrauma (MEB), which can lead to complaints of ear discomfort, stuffiness or fullness in the ear, and difficulties in equalizing ear pressure. The aim of this study is to evaluate the efficacy of self-acupressure in preventing and reducing the degree of MEB associated with HBOT. Read More

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[Hazard or Harmless Fun? Injuries Caused by Fireworks -Study at the University Emergency Department (2013-2019)].

Praxis (Bern 1994) 2021 Apr;110(6):336-347

Universitäres Notfallzentrum, Inselspital, Universitätsspital Bern.

Hazard or Harmless Fun? Injuries Caused by Fireworks -Study at the University Emergency Department (2013-2019) Fireworks are often used to celebrate national, cultural or religious events. Despite strict regulations, fireworks are repeatedly causing accidents. The risk for injuries increases with the incautious use of pyrotechnic articles. Read More

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Physiologically variable ventilation and severe asthma. Comment on Br J Anaesth 2020; 125: 1107-16.

W Alan C Mutch

Br J Anaesth 2021 06 24;126(6):e214. Epub 2021 Apr 24.

Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada. Electronic address:

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