Scientific papers 2022 - Part A
The documents are classified chronologically.
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Khodor Haidar Hassan, Joelle Azzi, Gian Marco Oppo,
Hadi Raef Rida, Roberto Vecchioni, Mohamad Ali
Chahrour, Mehdi Raef Rida, Fadel Nahle, Hadi Farhat,
Edwin Parra Prada, and Ahmad Najib Ballout.
Hyperbaric Oxygen Therapy (HBOT) is a recommended
treatment for all hypoxic pathologies and has been used
for decades as a recommended treatment for hypoxic-
ischemic and infectious disorders.
The pressures utilized vary from 2.2 to 2.8 ATA. 20
Osteoporosis patients treated underwent HBOT at 1.5 ATA
and 100% oxygen for 15 sessions.
Danilo Cialoni, Andrea Brizzolari, Alessandra Barassi,
Gerardo Bosco, Massimo Pieri, Valentina Lancellotti, and
Diving can influence changes in several hematological
parameters (HP) but the changes in HP in the
decompression phases are still unclear. This study
investigated any possible relationship between HP and
predisposition to inert gas bubble formation after a single
recreational dive. Blood, obtained from 32 divers, was
tested for differences in white blood cells, granulocytes,
lymphocytes, monocytes, red blood cells, and platelets
between bubblers and non-bubblers.
Authors: Sven Dreyer, Andreas Deussen, Dietmar Berndt,
and Jochen D. Schipke.
In 2012, a severe accident happened during the mission of
a saturation diver working at a depth of 90 m in the North
Sea. The dynamic positioning system of the diver support
vessel crashed, and the ship drifted away from the working
place, while one diver’s umbilical became snagged on a
steel platform and was severed. After 33 min, he was
rescued into the diving bell without exhibiting any
apparent neurological injury. The present case report tries
to reconstruct, on rational grounds, how the diver could
have survived after he was cut off from breathing gas, hot
water, light, and communication while 90 m deep at the
bottom of the sea.
Authors: Anders Rosén, Mikael Gennser, Nicklas Oscarsson,
Andreas Kvarnström, Göran Sandström, Helen
Seeman Lodding, Joel Simrén, Henrik Zetterberg.
This study aimed to determine if established markers of
neuronal injury were increased in the blood after diving.
Thirty-two divers performed two identical dives, 48 h apart,
in a water-filled hyperbaric chamber pressurized to an
equivalent of 42 m of seawater for 10 min. After one of the
two dives, normobaric oxygen was breathed for 30 min,
with air breathed after the other. Blood samples were
obtained before and at 30–45 and 120 min after diving.
Jerka Dumi, Ana Cvetko, Irena Abramovi, Sandra Šupraha
Goreta, Antonija Perovi , Marina Njire Braticevi, Domagoj
Kifer, Nino Sincic, Olga Gornik, and Marko Žarak.
A previous publication of the authors suggested that
repeated diving triggers an adaptive response of the
cardiovascular and immune
systems. To elucidate further molecular events underlying
cardiac and immune system adaptation and exclude
possible adverse effects, the authors measured blood levels
of specific cardiac and inflammation markers.
Linjie Wei, Chi Lin, Xingsen Xue, Shiju Jila, Yalan Dai, Li Pan,
Wei Wei, Guodong Dun, Yong Shen, Taoxi Zong, Jingjing
Wu, Yafang Li, Lixia Wu, Jishu Xian 3 and Anyong Yu
IThe prognosis of hypertensive intracerebral hemorrhage
(HICH) is poor at high altitudes. The objective of this study
was to explore whether hyperbaric oxygen (HBO) can
improve the results of computed tomography perfusion
(CTP) imaging and the neurological function of patients
with HICH, and influence the hemoglobin concentration.
This document is not directly related to diving. However, it
allows us to better understand the effect of oxygen on the
Kate Lambrechts, Peter Germonpré, Joaquim
Vandenheede, Manon Delorme, Pierre Lafère, and
Despite evolution in decompression algorithms,
decompression illness is still an issue nowadays. Reducing
vascular gas emboli (VGE) production or preserving
endothelial function by other means such as diving
preconditioning is of great interest. Several methods have
been tried, either mechanical, cardiovascular, desaturation
aimed or biochemical, with encouraging results. In this
study, the authors tested mini trampoline (MT) as a
Simon J. Mitchell, Michael H. Bennett, and Richard E.
Decompression sickness from dissolved gas causes tissue
and vascular injury after a reduction in environmental
pressure may occur in diving, aviation, and space flights.
Arterial gas embolism, in which bubbles introduced into
the arterial circulation cause multifocal ischemia, may
occur after diving-related, iatrogenic, accidental
pulmonary barotrauma or by the direct iatrogenic
introduction of gas into the vasculature. Because it may be
difficult to clinically differentiate decompression sickness
from an arterial gas embolism in divers and the treatment
protocols for the two disorders are the same, the term
decompression illness” is sometimes used to indicate the
presence of decompression sickness, arterial gas
embolism, or both, but the separate terms are used here.
Kamellia Karimpour, Rhiannon J. Brenner, Grant Z. Dong,
Jayne Cleve, Stefanie Martina, Catherine Harris, Gabriel J.
Graf, Benjamin J. Kistler, Andrew H. Hoang, Olivia Jackson,
Virginie Papadopoulou, and Frauke Tillmans.
Venous gas emboli (VGE) are a marker of decompression
stress, and large amounts of VGE are associated with an
increased probability of Decompression Sickness (DCS).
Thus, there is a need for small, portable devices with long
battery lives to obtain ultrasonic data in the field to assess
this variability better.
The authors compared two new handheld ultrasound
devices against a standard device currently used to
monitor post-dive VGE in the field.
Gordon Slater, Martin O’Malley, Tayla Slater, and Tandose
Hyperbaric Oxygen Therapy (HBOT) has been a
recognized treatment for a multitude of injuries for
decades and presents significant opportunities for the
improvement of wound healing, blood vessel restoration,
reduction in recovery time after surgery, treatment of
neurological and neurodegenerative disorders,
improvement of memory and cognition, sports injury
rehabilitation, cartilage regeneration, and overall quality of
life. This paper investigates HBOT and its indications for
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%)
Enrico Marchetti, Daniela Pigini, Mariangela Spagnoli,
Giovanna Tranfo, Flavia Buonaurio, Fabio Sciubba, Ottavia
Giampaoli, lfredo Miccheli, Alessandro Pinto, Nazzareno
De Angelis, and Luigi Fattorini
Oxidative stress after scuba diving has been explored by
measuring urinary biomarkers in volunteers under
controlled conditions. Dive depth and duration, water
temperature, and workload are all variables that can elicit
metabolic responses. A controlled diving experiment was
performed in an indoor pool at 20, 30, and 40 m depths at
a water temperature of 32C on three different days.
Ningfang Lian, Sijiao Wang, Lijuan Hu, Liping Xue, Ying
Gong, Li Li, Yanjie Yang, and Lei Zhu
This study aimed to evaluate the effects of a 500 m
simulated single saturation dive on lung function.
Nine professional divers aged (36 ± 7) years were enrolled.
Three days after the dive, the parameters related to
expiratory flow forced vital capacity (FVC)) were
decreased; the parameters about small airway function
decreased compared to those before the dive.
Additionally, after the dive, the parameters related to
pulmonary diffusion function were decreased compared
with those before the dive.,
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.
Ian L Millar, Folke G Lind, Karl-Åke Jansson, Michal
Hájek, David R Smart, Tiago D Fernandes, Rosemary A
McGinnes, Owen D Williamson, Russell K Miller, Catherine
A Martin, Belinda J Gabbe, Paul S Myles, Peter A Cameron,
for the HOLLT investigator group
Hyperbaric oxygen treatment (HBOT) is sometimes used in
the management of open fractures and severe soft tissue
crush injury, aiming to reduce complications and improve
outcomes. - Patients with open tibial fractures were
randomly assigned within 48 hours of injury to receive
standard trauma care or standard care plus 12 sessions of
HBOT. The primary outcome was the incidence of necrosis
or infection or both occurring within 14 days of injury.
Amilkar Almanza-Hurtado, Camilo Polanco Guerra, Marıa
Cristina Martınez-Avila, Diana Borre-Naranjo, Tomas
Rodrıguez-Yanez, and Carmelo Dueñas-Castell
Hypercapnia is the elevation in the partial pressure of
carbon dioxide (PaCO2) above 45 mmHg in the
bloodstream, pathophysiological mechanisms of
hypercapnia include the decrease in minute volume, an
increase in dead space, or an increase in carbon dioxide
(CO2) production per sec. They generate a compromise at
the cardiovascular, cerebral, metabolic, and respiratory
levels with a high burden of morbidity and mortality. It is
essential to know the triggers to provide therapy directed
at the primary cause and avoid possible complications.
(W. Rainey Johnson, Nicholas G. Roney, Hanbing Zhou,
Geoffrey E. Ciarlone, Brian T. Williams, William T. Green,
Richard T. Mahon, Hugh M. Dainer, Brett B. Hart, Aaron A.
In severe decompression illness (DCI) cases, the central
nervous system is often compromised (>80%), making DCI
among the most morbid of diving-related injuries. While
hyperbaric specialists suggest initiating recompression
therapy with either a Treatment Table 6 (TT6) or 6A (TT6A),
the optimal initial recompression treatment for severe DCI
Gerardo Bosco,Tommaso Antonio Giacon, Nazareno
Paolocci, Alessandra Vezzoli, Cinzia Della Noce, Matteo
Paganini, Jacopo Agrimi, Giacomo Garetto, Danilo
Cialoni, Natalie D’Alessandro, Enrico M. Camporesi,Simona
Divers can experience cognitive impairment due to inert
gas narcosis (IGN) at depth. Brain-derived neurotrophic
factor (BDNF) rules neuronal connectivity/metabolism to
maintain cognitive function and protect tissues against
oxidative stress (OxS). Dopamine and glutamate enhance
BDNF bioavailability. Thus, the authors hypothesized that
lower circulating BDNF levels underpin IGN in divers,
while testing if BDNF loss is associated with increased OxS.
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
Macklin effect accuracy for prediction of spontaneous
barotrauma was measured in terms of sensitivity,
specificity, positive (PPV) and negative predictive values