Dysbaric Illness

Alessandro Marroni1, Frans J. Cronje2, Jack Meintjes3 , Ramiro Cali-Corleo4

1 President and Medical Director, DAN Europe Foundation, Roseto, Italy 2 Medical Director of the Eugene Marais Hospital Hyperbaric Oxygen Therapy Center, Pretoria, South Africa.

Medical Advisor - Alexkor & Department of Labour - Diving; Senior Lecturer: Department of Community Health - Division of Occupational Health, University of Stellenbosch, South Africa. 4 Head of the Division of Baromedicine at the University of Malta and the Hyperbaric Unit, Malta

Abstract: Dysbaric Illness (DI) is a term that covers a broad range of complex pathophysiological conditions associated with decompression. Much of the actual etiology of DI remains unknown although the primary cause is believed to be the separation and/or the appearance of gas within the body, as result of decompression. Gas bubbles may originate from inert gas supersaturation or the traumatic injection of gas into the arterial circulation following pulmonary barotrauma. Their effects are multiple and manifestations of the condition are protean. This has led to the recommendation that any signs and symptoms, observed in individuals recently exposed to a reduction in environmental pressure, must be considered as being DI until proven otherwise. A high index of suspicion should be observed. Modern evidence-based medicine has offered mechanisms for the systematic evaluation of therapy and these have been applied to recompression and particularly adjunctive therapy for DI. This chapter provides an overview of the current state of understanding on DI and offers recommendations by the ECHM for the various methods of prevention and treatment

Keywords: caisson's disease; decompression sickness; decompression illness;

decompression; dysbarism; arterial gas embolism; gas bubble illness; gas bubble injury; bends

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