Adjunctive therapy including first aid

Adjunctive pharmacological treatment to recompression began to be emphasized in the late 60's and 1970's.

In 1979 the Undersea Medical Society organized a workshop on the management of severe and complicated cases of DI, where the importance of hydration, steroids, heparin, aspirin and other agents were discussed 133.

Over the years, many attempts have been made to improve the treatment of DI with other drugs - with limited success.

Some of these agents have not been sufficiently studied and may be deserving of additional attention: an example is the use of fluorocarbons. The latter has a higher solubility for nitrogen than plasma and may attenuate gas phase separation in extreme decompression scenarios like submarine escape. Lutz and Herrmann were able to substantially reduce the mortality of rats undergoing rapid decompression from 8 ata when fluorocarbon was infused after decompression 134.

Another area which deserves ongoing attention and study is complement activation and its effect on leukocyte-endothelium adhesion, which appears to be important in DI and possibly responsive to intervention with drugs.

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