Recompression Treatment After Decompression Sickness Clinical Trial
Official title:
Delayed Recompression for Decompression Sickness
Decompression sickness syndrome (DCS) is caused by microbubbles forming in blood vessels or
tissues during a reduction in environmental pressure (decompression). Bubbles have
mechanical, embolic and biochemical effects with manifestations ranging from none to fatal.
By reducing bubble volume and hastening inert gas elimination, recompression therapy with
hyperbaric treatment remains the main therapy for DCS. The most common hyperbaric protocol
used, is based on US Navy Treatment table 6, started as early as possible after surfacing.
The outcome of hyperbaric therapy varies with reported complete resolution in 13%-63% of the
patients suffering from severe DCS, and in 73%-100% of the patients with mild-moderate DCS.
The significance of time to recompression is controversial. It has been suggested that early
hyperbaric treatment improves the outcome by decreasing bubble size and avoiding further
tissue injury. However, in recent studies time to recompression had very little effect on
clinical recovery. Moreover, the time beyond which hyperbaric treatment isn't effective has
not been determined yet.
The aim of this study was to evaluate the clinical outcome of delayed hyperbaric treatment
to divers who referred to tertiary care hospital hyperbaric unit, more than 48 hours after
surfacing. The clinical outcome of the delayed hyperbaric treatments was compared to early
treatments given at the same hyperbaric unit.
From January 2000 to February 2014, 204 divers were treated for DCS in the institute of
Hyperbaric Medicine, Assaf Harofeh Medical Center, Israel.
The data will be collected retrospectively from medical records and include age, sex, diving
experience, maximal depth, DCS possible cause, DCS type, symptoms, time from surfacing to
symptoms onset, time from surfacing to recompression, recompression table, additional
treatment after the first recompression and treatment outcome.
Statistical analysis will be done using univariant analysis was performed using Spearman's
correlation and Chi-Square in categoric variabales, independent t-test in numeric variables.
This will be performed in SPSS v.21 software.
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Observational Model: Cohort, Time Perspective: Retrospective