Ultrasound in the diagnosis of acute-phase decompression sickness

Yanagawa, Youichi; Takeuchi, Ikuto; Ishiyama, Junzo

doi:10.1016/j.radcr.2021.01.004

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…After reaching shore, transportation to the hospital is carried out by the fire department for recompression treatment with hyperbaric oxygen (HBO) therapy. A physician-staffed helicopter emergency medical service (HEMS), of which base hospital is Juntendo Shizuoka Hospital, is necessary for such cases to diagnosis at scene and appropriate transport because there are no suitable hospitals for recompression in the Izu peninsula 3 , 4) . The HEMS can transport patients from the scene to a suitable hospital within 15 to 20 min.…”

Section: Introductionmentioning

confidence: 99%

“…Representatives from the fire department, coast guard, HEMS, and professional divers belonging to local dive shops in the Izu peninsula joined the meeting. At this meeting, we share information on the diving profile using a diving accident checklist ( Figure 1 ) newly developed by our own hospital; and review the proper, prompt management of patients with DCI, including early transportation 3 , 5) . After commencement of using the diving accident checklist, the list was deemed useful for helping the receiving hospital diagnose decompression sickness and determine the recompression table 6) .…”

Section: Introductionmentioning

confidence: 99%

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A Diving Accident Checklist in Izu Peninsula can be Associated with Some Pitfalls

Onitsuka

Tada

Nozawa

et al. 2023

Juntendo Medical Journal

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Objective: We retrospectively investigated the degree of completion of the checklist during or immediately after diving accident, who were transported by a physician-staffed helicopter emergency medical service (HEMS). Method:From May 2016 to December 2020, we conducted a retrospective the diving accident checklist review of all patients with diving accident, who were transported by HEMS. If all questions of the diving accident checklist were answered, full marks were 40 points. Subjects were divided into two groups: the Arrest group, which included subjects who became cardiac arrest in prehospital setting, and the Control group. Results: A total of 86 patients with diving accident were transported by the HEMS. Among these patients, there were 16 subjects in the Arrest group and 70 in the Control group. Average total score in the Arrest group were significantly smaller than those in the Control group. Conclusion:Degree of completion of the diving accident checklist in cases with cardiac arrest was low in comparison with cases without cardiac arrest. To improve this, further approach based on several remedies will be required in the future.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Diving Accident Checklist in Izu Peninsula can be Associated with Some Pitfalls

Onitsuka

Tada

Nozawa

et al. 2023

Juntendo Medical Journal

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“…Patient's TTE after HBOT: the disappearance of the microbubbles. (TTE, transthoracic echocardiography; HBOT, hyperbaric oxygen therapy; RV, right ventricle; MV, mitral valve) T A B L E 1 Identified published cases of bubbles detection using ultrasound in DCS patients Case Yanagawa et al, 202113 Jitsuiki et al, 202014 Kondo et al, 201815 …”

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confidence: 99%

Right cardiac chambers echo‐bubble contrast in a patient with decompression sickness: A case report and a literature review

Harfoush

Ramadan

Hamdallah

2022

Clinical Case Reports

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The diagnosis of decompression sickness (DCS) is mostly based on clinical suspicion, and there is currently no available modality to fully confirm the diagnosis. However, the use of echocardiography in suspected DCS cases has become more common. In this case, transthoracic echocardiography (TTE) was used to detect microbubbles in the right cardiac chambers and monitor the patient after hyperbaric oxygen therapy (HBOT), suggesting the possible applicability of TTE in diagnosing and monitoring DCS patients. This report describes a 54‐year‐old Fisherman who was referred to the emergency department with dyspnea and mild confusion after a rapid ascent of a saturation dive at 50 m sea depth. After the initial evaluation, he was assessed using TTE to exclude the presence of structural heart disease, where it surprisingly showed spontaneous echo contrast inside the right cardiac chambers similar to agitated saline echo testing. The patient was then admitted for HBOT and follow‐up; rapid improvement was noticed after the first HBOT session and the TTE findings were fully resolved. TTE could be considered in the initial workup when DCS is suspected, and it might have a role in monitoring DCS patients if echocardiographic findings of bubble formation were documented in the pre‐hyperbaric therapy settings.

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3D simulation of pulsatile bubbly flow resembling decompression sickness conditions inside a realistic human artery

Evgenidis,

Karapantsios

2024

Exp. Comput. Multiph. Flow

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I-VED (In-Vivo Embolic Detector) is a novel diagnostic tool for non-invasive, real-time detection of bubbles in humans. Bubbles are precursors of decompression sickness (DCS), which can be encountered in astronauts, scuba divers, etc. I-VED exploits an EU patented electrical impedance spectroscopy technology, developed under the umbrella of a European Space Agency project. So far, I-VED has been calibrated and validated in vitro. In view of the forthcoming in-vivo trials, it needs to be configured for sensing bubbles in the bloodstream. For this, 3D computational fluid dynamics simulation is performed to investigate axial and radial variation of void fraction (α) and flow velocity (U) in a pulsatile bubbly flow inside a realistic human artery (diameter: 5–20 mm, implying vessel dilatation or contraction), where liquid velocity, bubble size, and void fraction resemble DCS conditions. Results show that U and α show a core-peaking profile despite the variation of artery diameter, while 3D sharp turns yield U and α non-uniformities in the angular direction that do not affect mean void fraction across the artery. Obtained knowledge allows deeper insight on the physics and spatial characteristics of bubbly flow in a real artery, which is useful in the design of measuring volume and tuning of I-VED.

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Ultrasound in the diagnosis of acute-phase decompression sickness

Cited by 3 publications

References 9 publications

A Diving Accident Checklist in Izu Peninsula can be Associated with Some Pitfalls

A Diving Accident Checklist in Izu Peninsula can be Associated with Some Pitfalls

Right cardiac chambers echo‐bubble contrast in a patient with decompression sickness: A case report and a literature review

3D simulation of pulsatile bubbly flow resembling decompression sickness conditions inside a realistic human artery

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