Scientific papers 2022 - Part A
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Authors:
Zachary M. Harris, Ying Sun, John Joerns, Brian Clark, Buqu
Hu, Asawari Korde, Lokesh Sharma, Hyeon Jun Shin,
Edward P. Manning, Lindsey Placek, Derya Unutmaz, Gail
Stanley, Hyung Chun, Maor Sauler, Govindarajan
Rajagopalan, Xuchen Zhang, Min-Jong Kang, and
Jonathan L. Koff
Studies have linked severe hyperoxia, or prolonged
exposure to very high oxygen levels, with worse clinical
outcomes. This study investigated the role of epidermal
growth factor receptor (EGFR) in hyperoxia-induced lung
injury at very high oxygen levels (>95%)
Authors: Maria Ludovica Carerj, Giuseppe Bucolo, Silvio
Mazziotti, Alfredo Blandino, Christian Booz,
Giuseppe Cicero, Tommaso D’Angelo.
Pneumothorax and pneumomediastinum are life-
threatening conditions especially in critically ill patients.
One of the most common situations in which they occur is
prolonged invasive and non-invasive mechanical
ventilation with high end-expiratory pressure. Probably
due to the high number of patients with SARS-CoV-2
respiratory infection being treated with mechanical
ventilation, increasing number of pulmonary barotrauma
cases have been reported.
Authors:
Dhan Bahadur Shrestha, Yub Raj Sedhai, Pravash
Budhathoki, Ayush Adhikari, Nisheem Pokharel, Richa
Dhakal, Satyasuna Kafle, Wasey Ali Yadullahi Mir, Roshan
Acharya, Markos G. Kashiouris, Mark S. Parker
Numerous studies have reported an increased incidence
of spontaneous pulmonary barotrauma, such as
pneumothorax, pneumomediastinum, and subcutaneous
emphysema in patients with COVID-19. The authors
conducted this systematic review and meta-analysis to
assess the value and significance of the available data.
Authors:
Gianluca Paternoster, Gianfranco Belmonte, Enrico
Scarano, Pietro Rotondo, Diego Palumbo , Alessandro
Belletti, Francesco Corradi , Pietro Bertini, Giovanni
Landoni, Fabio Guarracino
This is an observational, case-control study.
Consecutive COVID-19 patients who underwent chest
CT scan at hospital admission during the study time
period (October 1st, 2020 – April 31st, 2021) were
identified.
Macklin effect accuracy for prediction of spontaneous
barotrauma was measured in terms of sensitivity,
specificity, positive (PPV) and negative predictive values
(NPV)..
Authors: Levent Demir & Mustafa Avci
The objective of the study was to compare pulmonary
function tests results of hyperbaric chamber inside
attendants (HCIAs) working in a hyperbaric chamber
before and after sessions.
Authors: Saleh Eltarabily
The purpose of this study was to determine whether there
is a correlation between a hyperbaric environment, or
increased oxygen partial pressure, and the corrosion of
dental alloys used for dental restorations in divers.
Authors: Dr. med. Jens Strohäker, Dr. med. Malte Bongers,
Dr. med. Robert Bachmann
A 63-year-old man experienced a coughing fit and felt a
tearing sensation in the right hemithorax. Clinical
examination showed thoracic instability with attenuated
breath sounds and an extensive soft tissue hematoma. The
patient’s dyspnea worsened, and he was transferred to
Tübingen University Hospital for surgery.
Authors: Santiago Veiga, Robin Pla, Xiao Qiu, David
Boudet, and alexandre Guimard
The authors of this study examined the effects of changes
in underwater sections of swimming races on the
physiological and biomechanical parameters of
competitive swimmers. The results indicate that while
overall performance was maintained and underwater
section durations increased as expected, heart rate and
blood lactate concentration did not differ significantly
between conditions. However, perceived exertion was
higher in constrained underwater than free underwater
conditions, leading to the conclusion that controlled
increases in underwater sections can optimize
performance despite a slight increase in perceived
discomfort.
Authors:
Robert P. Ostrowski, Emanuela Pucko and Ewa Matyja
This study investigates the role of the proteasome in
hyperbaric oxygen preconditioning (HBO-PC) to protect
the brain from ischaemic injury. It documents experiments
in male Wistar rats subjected to global cerebral ischaemia
and preconditioned with HBO and details the methods,
results, and significance of the findings, highlighting that
HBO-PC reduces neuronal damage and improves
functional outcomes, possibly through proteasome
involvement and modulation of apoptosis-related
proteins.
Authors:
Mirela Zec, Vesna Anticevic, Linda Lušis Kalcina, Zoran
Valic, Joško Božic
This study investigates the relationship between negative
automatic thoughts, negative emotions, and
psychophysiological stress responses in military and
recreational divers to determine whether these
psychological factors, rather than diving experience,
contribute to variations in stress responses, as measured by
anxiety levels and cortisol secretion. It also highlights the
importance of considering cognitive and emotional
experiences, especially in recreational divers, to prevent
negative stress responses before diving.
Authors:
Xavier C. E. Vrijdag, Hanna van Waart, Rebecca M. Pullon,
Chris Sames, Simon J. Mitchell, and Jamie W. Sleigh
This study investigates the effects of nitrogen narcosis on
cognitive function during hyperbaric conditions, using
electroencephalogram (EEG) functional connectivity
metrics by comparing the effects of breathing air, which
contains nitrogen, and heliox, which does not have
narcotic effects at the pressure mwentioned. The findings
suggest that nitrogen narcosis increases functional
connectivity in the brain, which is associated with cognitive
impairment, while heliox does not cause such changes.
Authors:
Shodai Moriyama, Masashi Ichinos, Kohei Dobashi, Ryoko
Matsutake, Mizuki Sakamoto, Naoto Fuji, Takeshi Nishiyasu
This study investigated the effects of increased arterial
carbon dioxide pressure on vascular and blood flow
responses in the cerebral circulation and active skeletal
muscles during dynamic exercise in humans by comparing
hypercapnia and normocapnia trials to observe differences
in blood flow and vascular conductance in the brain and
exercising muscles. The results highlight contrasting
vascular responses in the cerebral circulation and skeletal
muscles under hypercapnic conditions.
Authors: Danilo A. Massini, Danilo Scaggion, Thiago P. de
Oliveira, Anderson G. Macedo, Tiago A. Almeida,
Dalton M. Pessôa Filho.
The authors of this document present the findings of a
systematic review and meta-analysis that aimed to identify
and evaluate the effectiveness of different training
methods used to improve static apnea time performance
in freediving. The review summarizes the evidence
acquisition and synthesis, highlighting the effectiveness of
three different training methods, and concludes that while
all methods were effective, it is not possible to recommend
an ideal protocol for improving apnea time and freediving
performance based on the existing studies.
6 - Does hyperbaric oxygen therapy facilitate peripheral nerve
recovery in upper extremity injuries? A prospective study of 74
patients
- Published by the European of Trauma and Emergency Surgery - Springer Nature.
Authors: Bilsev Ince, Majid Ismayilzada, Abdullah Arslan,
Mehmet Dadaci
This study assessed the effectiveness of hyperbaric oxygen
therapy (HBOT) in upper extremity nerve injuries. Patients
with ulnar and median nerve injuries from 2015 to 2019
were included and divided into two groups: one received
HBOT after surgery, while the other did not. Follow-ups
were done at 3, 6, and 12 months using various tests.
Results showed that the HBOT group had faster nerve
recovery and better muscle strength than the group
without HBOT, suggesting that HBOT is beneficial.
Authors: Denis Martinvalet, and Michael Walch
Reactive oxygen species (ROS) are a type of oxygen
reduction that contributes to various physiological
processes, including inflammation, vasoconstriction, signal
transduction, cell migration, differentiation, and
proliferation. They can modulate genes expression and
transcriptional levels, and regulate gene expression at the
posttranscriptional level. ROS are crucial for cell biology,
organ function, and system physiology, including the
immune system. This Research Topic aims to explore how
ROS contribute to protective immunity, despite their
potential harm.
Authors: Busra Dilara Altun, Selin Gamze Sümen, Asim
Dumlu
This case report details dental barotrauma and
barodontalgia experienced by a diving physician during
hyperbaric oxygen treatment. The physician suffered
intense, localized pain in their right maxillary molars,
radiating to the face, ear, and head, during
decompression from 2.4 ATA. This pain, consistent with
irreversible pulpitis, was attributed to a fracture of a heavily
restored tooth caused by pressure changes.
Management involved tooth extraction. The physician
ceased participating in hyperbaric sessions. Dental
specialists advise a minimum four-week healing period
before further pressure exposure to prevent infection or
re-injury.
Authors: Kwan Leong Au-Yeung, Christopher Selvaraj,
Tajrian Amin, Lawrence K Ma, Michael H Bennett
Infrared thermometry is used to assess metabolic activity
and may aid in identifying patients with ulcers for
hyperbaric oxygen treatment. This pilot study examined
the effect of oxygen administration (21%, 50%, 100%) on
lower limb skin temperature in healthy subjects and
diabetic patients. Mean foot temperatures showed minor
changes with increasing oxygen levels, but no statistically
significant differences were observed between groups at
any oxygen concentration.
Authors: Sylvain Boet, Joseph K Burns, Eric Jenisset,
Mélanie Papp, Sylvie Bourbonnais, Rodrigue
Pignel
Simulation-based education enhances practices and
patient outcomes across healthcare but remains
underutilized in hyperbaric medicine. To address this gap,
researchers employed a modified Delphi method to
identify critical clinical scenarios for a hyperbaric medicine
simulation curriculum. Using an international, bilingual
questionnaire and consensus thresholds, participants from
nine countries, including physicians and non-physicians,
prioritized scenarios through two rounds. Five scenarios
emerged as essential: seizure, fire, cardiac arrest,
pneumothorax, and technical deficiencies.
Authors: Peter Buzzacott, Charles Edelson, James Chimiak,
Frauke Tillmans
This study examined active adult scuba divers in the US,
comparing their health and wellbeing characteristics with
other physically active adults. Using BRFSS data
(2011–2023), researchers analyzed 103,686,087 person-
years of data, including 14,360 person-years of scuba-
related records. Divers typically dove once weekly for
about two hours total. Compared to matched peers,
divers were more likely to earn over $50,000 annually, less
likely to be married, had fewer children, and more often
owned their homes. They also reported better overall
health and mental health, greater financial access to
healthcare, and a 16% higher likelihood of being
overweight.
Authors: Derek B Covington, Charlotte Sadler, Anthony
Bielawski, Gareth Lock, Andrew Pitkin
Redundancy is essential in extended-range cave diving,
providing backup regulators, gauges, lights, and gas for
safe exits and emergencies. Open-circuit gas needs often
exceed what a diver can carry, prompting in-cave cylinder
staging or support-diver resupply, with notable
drawbacks. Closed-circuit rebreathers (CCR) extend range
through gas efficiency, but deeper dives require planning
for open-circuit bailout if the CCR fails. Staging cylinders
faces challenges from the complexity of placement and
corrosion during long dives. As a result, many CCR divers
carry a bailout CCR, though the risks of dual complex
systems remain unclear.
Authors: Abdurrahman E Demir, Savas Ilbasmis, Akin S
Toklu
SARS-CoV-2 (COVID-19), declared a global pandemic in
March 2020, poses a significant public health threat,
particularly in enclosed settings like hyperbaric oxygen
treatment (HBOT) units due to droplet and aerosol
transmission risks. A case involving a 16-year-old female
testing positive for COVID-19 during HBOT led to contact
tracing and quarantining of others in the unit, all of whom
tested negative. The clinic’s strict preventive measures,
treating every patient as a potential asymptomatic carrier,
effectively prevented transmission, as evidenced by no
further confirmed cases. This case underscores that robust
protective measures can mitigate COVID-19 spread in
high-risk environments.
Authors: Bengusu Mirasoglu, Gulsen Yetis, Mustafa Erelel,
Akin Savas Toklu
This study investigated COVID-19 related changes that
could disqualify divers. Its authors analyzed 43 divers
seeking fitness-to-dive assessments post-infection. Thirteen
divers were disqualified, all due to persistent lung changes
on CT scans. While initial CT lesions were common
(68.2% at diagnosis, 73.3% within three months), they
persisted in 19.2% of cases later, primarily as ground-glass
opacities and fibrotic changes. Demographics and
COVID-19 history did not differentiate those disqualified
from those cleared.
Authors: Handan Ozturk, Bengusu Mirasoglu, Samil Aktas
Intractable haemorrhagic cystitis (HC) after chemotherapy
and HSCT is a serious complication, and hyperbaric
oxygen treatment (HBOT) has emerged as a promising
option due to similarities with radiation-induced HC where
it is approved. In this retrospective study, 25 patients
treated with HBOT from 2000 to 2020 were analyzed,
with a median of 12 sessions per patient. Complete
healing occurred in 11 patients and haematuria improved
in seven; HC grades after HBOT were significantly better
than at referral, and greater benefit correlated with the
number of HBOT sessions, particularly for seven or more
sessions. These findings support HBOT as an effective
treatment for CT/HSCT-associated HC.
Authors: Carolina Romano-Ribeiro, Clara Gaio-Lima,
António P Ferreira, Belinda Oliveira, Marta Dias-
Vaz, Óscar Camacho
Pneumorrhachis is a rare condition that often does not
cause symptoms. This case reports a symptomatic epidural
pneumorrhachis after using loss-of-resistance to saline
during epidural placement in a 32-year-old woman
undergoing an emergency cesarean section. After starting
an anesthetic infusion post-surgery, she developed motor
issues. A CT scan revealed pneumorrhachis, and she
underwent hyperbaric oxygen therapy, leading to her
complete recovery.
Authors: Charlotte Sadler, Miguel Alvarez-Villela, Karen
Van Hoesen, Ian Grover, Michael Lang, Tom
Neuman, Peter Lindholm
This update revises the University of California, San Diego
(UCSD) Dive Clinic's 2020 COVID-19 diving evaluation
guidelines based on recent developments, like
vaccinations and milder virus symptoms. The guidance
now treats mild COVID-19 like other seasonal viruses, with
unclear significance for certain heart inflammation
findings. Recommendations for moderate/severe cases
remain the same, and changes apply only to fully
asymptomatic divers with normal exercise capacity.
Authors: Marguerite St Leger Dowse, Matthew K
Waterman, Rhodri Jones, Gary R Smerdon
A UK survey of 790 recreational divers (64% male, median
age 47) found a high prevalence of otological disorders:
40% showed Eustachian tube dysfunction (ETD) per
ETDQ-7 scores (≥2.1), and 79% reported ear problems
(external, middle, or inner) since starting diving—yet 46%
sought no medical advice. Among those with ear issues,
47% had ETDQ-7 scores indicating ETD. Six cases of inner
ear decompression sickness were reported. Decongestant
use was reported by 23%, and 35% aborted dives due to
ear problems. Critically, only 27% were aware of the UK
Diving Medical Committee’s ear health guidance
