Lower risk of decompression sickness after recommendation of conservative decompression practices in divers with and without vascular right-to-left shunt

• Verfasst von: Klingmann, Christoph [VerfasserIn]
• Verfasst von: Rathmann, Nils-Andreas [VerfasserIn]
• Verfasst von: Hausmann, Daniel [VerfasserIn]
• Verfasst von: Bruckner, Thomas [VerfasserIn]
• Verfasst von: Kern, Rolf [VerfasserIn]
• Titel: Lower risk of decompression sickness after recommendation of conservative decompression practices in divers with and without vascular right-to-left shunt
• Verf.angabe: Christoph Klingmann, Nils Rathmann, Daniel Hausmann, Thomas Bruckner, Rolf Kern
• E-Jahr: 2012
• Jahr: 2012 Sept.
• Umfang: 5 S.
• Fussnoten: Gesehen am 24.10.2018
• Titel Quelle: Enthalten in: Diving and hyperbaric medicine
• Ort Quelle: Melbourne, Victoria : SPUMS, 2006
• Jahr Quelle: 2012
• Band/Heft Quelle: 42(2012), 3, Seite 146-150
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Adult
• Sach-SW: Aged
• Sach-SW: Decompression
• Sach-SW: Decompression Sickness
• Sach-SW: Diving
• Sach-SW: Female
• Sach-SW: Follow-Up Studies
• Sach-SW: Guideline Adherence
• Sach-SW: Heart Septal Defects, Atrial
• Sach-SW: Humans
• Sach-SW: Male
• Sach-SW: Middle Aged
• Sach-SW: Nitrogen
• Sach-SW: Retrospective Studies
• Sach-SW: Risk
• Sach-SW: Risk Management
• Sach-SW: Secondary Prevention
• K10plus-PPN: 1582237948

Abstract

Introduction: A vascular right-to-left shunt (r/l shunt) is a well-known risk factor for the development of decompression sickness (DCS). No studies to date have examined whether divers with a history of DCS with or without a r/l shunt have a reduced risk of suffering recurrent DCS when diving more conservative dive profiles (CDP). Methods: Twenty-seven divers with a history of DCS recommended previously to dive more conservatively were included in this study and retrospectively interviewed by phone to determine the incidence of DCS recurrence.RESULTS: Twenty-seven divers performed 17,851 dives before examination in our department and 9,236 after recommendations for conservative diving. Mean follow up was 5.3 years (range 0-11 years). Thirty-eight events of DCS occurred in total, 34 before and four after recommendation of CDP. Four divers had a closure of their patent foramen ovale (PFO). A highly significant reduction of DCS risk was observed after recommendation of CDP for the whole group as well as for the sub-groups with or without a r/l shunt. A significant reduction of DCS risk in respect to r/l shunt size was also observed.DISCUSSION: This study indicates that recommendations to reduce nitrogen load after DCS appear to reduce the risk of developing subsequent DCS. This finding is independent of whether the divers have a r/l shunt or of shunt size. The risk of suffering recurrent DCS after recommendation for CDP is less than or equal to an unselected cohort of divers.Conclusion: Recommendation for CDP seems to significantly reduce the risk of recurrent DCS.