decompression sickness

Summary

Summary: A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death.

Top Publications

  1. Fernandez A, Edwards J, Rodriguez F, Espinosa de los Monteros A, Herraez P, Castro P, et al. "Gas and fat embolic syndrome" involving a mass stranding of beaked whales (family Ziphiidae) exposed to anthropogenic sonar signals. Vet Pathol. 2005;42:446-57 pubmed
    ..caused nitrogen supersaturation above a threshold value normally tolerated by the tissues (as occurs in decompression sickness)...
  2. Blatteau J, Gempp E, Simon O, Coulange M, Delafosse B, Souday V, et al. Prognostic factors of spinal cord decompression sickness in recreational diving: retrospective and multicentric analysis of 279 cases. Neurocrit Care. 2011;15:120-7 pubmed publisher
    This study aims to determine the potential risk factors associated with the development of severe diving-related spinal cord decompression sickness (DCS).
  3. Arieli R, Svidovsky P, Abramovich A. Decompression sickness in the rat following a dive on trimix: recompression therapy with oxygen vs. heliox and oxygen. J Appl Physiol (1985). 2007;102:1324-8 pubmed
    ..There is no specific recompression treatment for decompression sickness (DCS) resulting from trimix diving...
  4. Fitz Clarke J. Risk of decompression sickness in extreme human breath-hold diving. Undersea Hyperb Med. 2009;36:83-91 pubmed
    The risk of decompression sickness (DCS) in human breath-hold diving is expected to increase as dives progress deeper until a depth is reached where total lung collapse stops additional nitrogen gas uptake...
  5. Yoshiyama M, Asamoto S, Kobayashi N, Sugiyama H, Doi H, Sakagawa H, et al. Spinal cord decompression sickness associated with scuba diving: correlation of immediate and delayed magnetic resonance imaging findings with severity of neurologic impairment--a report on 3 cases. Surg Neurol. 2007;67:283-7 pubmed
    ..We report on the cases of 3 patients diagnosed with spinal cord DCS presenting with severe neurologic symptoms after scuba diving...
  6. Blatteau J, Gempp E, Constantin P, Louge P. Risk factors and clinical outcome in military divers with neurological decompression sickness: influence of time to recompression. Diving Hyperb Med. 2011;41:129-34 pubmed
    This study was designed to examine the influence of short delay to recompression and other risk factors associated with the development of severe neurological decompression sickness (DCS) in military divers.
  7. Tyack P, Johnson M, Soto N, Sturlese A, Madsen P. Extreme diving of beaked whales. J Exp Biol. 2006;209:4238-53 pubmed
    ..If the assumptions of these models are correct for beaked whales, then possible decompression problems are more likely to result from an abnormal behavioural response to sonar...
  8. Ni X, Ni M, Fan D, Sun Q, Kang Z, Cai Z, et al. Heat-shock protein 70 is involved in hyperbaric oxygen preconditioning on decompression sickness in rats. Exp Biol Med (Maywood). 2013;238:12-22 pubmed publisher
    b>Decompression sickness (DCS) is a major concern in diving and space walk. Hyperbaric oxygen (HBO) preconditioning has been proved to enhance tolerance to DCS via nitric oxide...
  9. Hooker S, Baird R, Fahlman A. Could beaked whales get the bends? Effect of diving behaviour and physiology on modelled gas exchange for three species: Ziphius cavirostris, Mesoplodon densirostris and Hyperoodon ampullatus. Respir Physiol Neurobiol. 2009;167:235-46 pubmed publisher
    ..duration, changes in ascent rate, diel behaviour) would lead to differences in P(N2) levels and thereby decompression sickness (DCS) risk between species...

More Information

Publications62

  1. Butler B, Little T, Cogan V, Powell M. Hyperbaric oxygen pre-breathe modifies the outcome of decompression sickness. Undersea Hyperb Med. 2006;33:407-17 pubmed
    Deep sea divers, aviators and astronauts are at risk of decompression sickness when the ambient pressure reductions exceed a critical threshold...
  2. Cianci P, Slade J. Delayed treatment of decompression sickness with short, no-air-break tables: review of 140 cases. Aviat Space Environ Med. 2006;77:1003-8 pubmed
    Most cases of decompression sickness (DCS) in the U.S. are treated with hyperbaric oxygen using U.S. Navy Treatment Tables 5 and 6, although detailed analysis shows that those tables were based on limited data...
  3. Brubakk A, Duplancic D, Valic Z, Palada I, Obad A, Bakovic D, et al. A single air dive reduces arterial endothelial function in man. J Physiol. 2005;566:901-6 pubmed
    ..Further studies are needed to determine if these mechanisms are involved in tissue injury following diving...
  4. Fahlman A, Olszowka A, Bostrom B, Jones D. Deep diving mammals: Dive behavior and circulatory adjustments contribute to bends avoidance. Respir Physiol Neurobiol. 2006;153:66-77 pubmed
    ..This has important implications as small reductions in inert gas load (approximately 5%) can substantially reduce decompression sickness (DCS) risk by as much as 50% (Fahlman et al., 2001, J. Appl. Physiol. 91, 2720-2729).
  5. Blatteau J, Gempp E, Balestra C, Mets T, Germonpre P. Predive sauna and venous gas bubbles upon decompression from 400 kPa. Aviat Space Environ Med. 2008;79:1100-5 pubmed
    ..This study investigated the influence of a far infrared-ray dry sauna-induced heat exposure before a simulated dive on bubble formation, and examined the concomitant adjustments in hemodynamic parameters...
  6. Montcalm Smith E, Fahlman A, Kayar S. Pharmacological interventions to decompression sickness in rats: comparison of five agents. Aviat Space Environ Med. 2008;79:7-13 pubmed
    This research investigated whether decompression sickness (DCS) risk or severity could be reduced using drug interventions that are easier to implement and equal to or more efficacious than recompression therapy.
  7. Eftedal O, Lydersen S, Brubakk A. The relationship between venous gas bubbles and adverse effects of decompression after air dives. Undersea Hyperb Med. 2007;34:99-105 pubmed
    ..the relationship between the amount of bubbles detected by ultrasound Doppler systems and the incidence of decompression sickness. The use of ultrasound imaging has some important advantages to Doppler systems, and here we have looked ..
  8. Vann R, Butler F, Mitchell S, Moon R. Decompression illness. Lancet. 2011;377:153-64 pubmed publisher
    ..gas emboli (via cardiac shunts or via pulmonary vessels) are introduced into the arterial circulation, and decompression sickness, which is caused by in-situ bubble formation from dissolved inert gas...
  9. Blatteau J, Gempp E, Galland F, Pontier J, Sainty J, Robinet C. Aerobic exercise 2 hours before a dive to 30 msw decreases bubble formation after decompression. Aviat Space Environ Med. 2005;76:666-9 pubmed
    ..The purpose of this investigation was to determine the effect of aerobic exercise 2 h before a dive...
  10. Li J, Wong W. Two-dimensional toxic dose and multivariate logistic regression, with application to decompression sickness. Biostatistics. 2011;12:143-55 pubmed publisher
    ..An example of the need for such a method is a decompression sickness (DCS) study in which each animal subject is examined for the presence of multiple types of DCS...
  11. Gempp E, Blatteau J. Risk factors and treatment outcome in scuba divers with spinal cord decompression sickness. J Crit Care. 2010;25:236-42 pubmed publisher
    This study was designed to determine the recompression strategy and the potential risk factors associated with the development of severe diving-related spinal cord decompression sickness (DCS).
  12. Arieli R, Boaron E, Abramovich A. Combined effect of denucleation and denitrogenation on the risk of decompression sickness in rats. J Appl Physiol (1985). 2009;106:1453-8 pubmed publisher
    ..hypothesized that the number of bubbles emerging on decompression from a dive, and the resultant risk of decompression sickness (DCS), may be reduced by a process whereby effective gas micronuclei that might otherwise have formed ..
  13. Thom S, Yang M, Bhopale V, Huang S, Milovanova T. Microparticles initiate decompression-induced neutrophil activation and subsequent vascular injuries. J Appl Physiol (1985). 2011;110:340-51 pubmed publisher
    ..We conclude that MPs generated by decompression stresses precipitate neutrophil activation and vascular damage...
  14. Eftedal O, Tjelmeland H, Brubakk A. Validation of decompression procedures based on detection of venous gas bubbles: A Bayesian approach. Aviat Space Environ Med. 2007;78:94-9 pubmed
    Verification of new decompression procedures has traditionally been based on observing the occurrence of decompression sickness (DCS) in test dives...
  15. Grønning M, Risberg J, Skeidsvoll H, Moen G, Aanderud L, Troland K, et al. Electroencephalography and magnetic resonance imaging in neurological decompression sickness. Undersea Hyperb Med. 2005;32:397-402 pubmed
    ..of electroencephalography (EEG) and magnetic resonance imaging (MRI) in the clinical evaluation of acute decompression sickness (DCS) in the central nervous system (CNS)...
  16. Dujic Z, Palada I, Valic Z, Duplancic D, Obad A, Wisløff U, et al. Exogenous nitric oxide and bubble formation in divers. Med Sci Sports Exerc. 2006;38:1432-5 pubmed
    ..This study determined whether a short-lasting NO donor, nitroglycerine, reduced bubble formation after standard dives and decompression in man...
  17. Blatteau J, Souraud J, Gempp E, Boussuges A. Gas nuclei, their origin, and their role in bubble formation. Aviat Space Environ Med. 2006;77:1068-76 pubmed
    Gas bubbles are the primary agent in producing the pathogenic effects of decompression sickness. Bubble formation during decompression is not simply the consequence of inert gas supersaturation...
  18. Weisher D. Resolution of neurological DCI after long treatment delays. Undersea Hyperb Med. 2008;35:159-61 pubmed
    We report two interesting cases in which both divers sustained a very serious Type II decompression sickness. This involved substantial neurological impairment which was successfully treated despite having a delayed treatment time 12 ..
  19. Dujic Z, Obad A, Palada I, Ivancev V, Valic Z. Venous bubble count declines during strenuous exercise after an open sea dive to 30 m. Aviat Space Environ Med. 2006;77:592-6 pubmed
    ..The objective of this study was to determine whether a short period of strenuous post-dive exercise promotes venous bubble formation...
  20. Møllerløkken A, Berge V, Jørgensen A, Wisløff U, Brubakk A. Effect of a short-acting NO donor on bubble formation from a saturation dive in pigs. J Appl Physiol (1985). 2006;101:1541-5 pubmed
    ..2 to 0.02 bubbles/cm(2) (P < 0.0001) in the experimental group compared with the controls. The present study gives further support to the role of NO in preventing vascular bubble formation after decompression...
  21. Van Bonn W, Montie E, Dennison S, Pussini N, Cook P, Greig D, et al. Evidence of injury caused by gas bubbles in a live marine mammal: barotrauma in a California sea lion Zalophus californianus. Dis Aquat Organ. 2011;96:89-96 pubmed publisher
    ..This is the first instance of clinical injury due to gas bubble formation described in a living pinniped and the first sea lion with quantifiable cerebellar damage to take part in spatial learning and memory testing...
  22. Schipke J, Gams E, Kallweit O. Decompression sickness following breath-hold diving. Res Sports Med. 2006;14:163-78 pubmed
    Despite convincing evidence of a relationship between breath-hold diving and decompression sickness (DCS), the causal connection is only slowly being accepted...
  23. Ni X, Cai Z, Fan D, Liu Y, Zhang R, Liu S, et al. Protective effect of hydrogen-rich saline on decompression sickness in rats. Aviat Space Environ Med. 2011;82:604-9 pubmed
    ..to be effective in the treatment of oxidative injury, which plays an important role in the process of decompression sickness (DCS)...
  24. Fan D, Liu K, Xu W, Zhang R, Liu Y, Kang Z, et al. Hyperbaric oxygen preconditioning reduces the incidence of decompression sickness in rats via nitric oxide. Undersea Hyperb Med. 2010;37:173-80 pubmed
    Divers are at risk of decompression sickness (DCS) when the ambient pressure decrease exceeds a critical threshold...
  25. Germonpre P, Pontier J, Gempp E, Blatteau J, Deneweth S, Lafère P, et al. Pre-dive vibration effect on bubble formation after a 30-m dive requiring a decompression stop. Aviat Space Environ Med. 2009;80:1044-8 pubmed
    The preconditioning of divers to reduce post-dive decompression sickness (DCS) has gained increased interest in diving medical research over the last few years...
  26. Gao G, Wu D, Yang Y, Yu T, Xue J, Wang X, et al. Cerebral magnetic resonance imaging of compressed air divers in diving accidents. Undersea Hyperb Med. 2009;36:33-41 pubmed
    ..The MRI of brain is an sensitive method for detecting cerebral lesions in compressed air divers in diving accidents. The MRI should be finished on divers in diving accidents within 5 days...
  27. Dujic Z, Palada I, Obad A, Duplancic D, Bakovic D, Valic Z. Exercise during a 3-min decompression stop reduces postdive venous gas bubbles. Med Sci Sports Exerc. 2005;37:1319-23 pubmed
    b>Decompression sickness is initiated by the formation of gas bubbles in tissue and blood if the divers return to surface pressure too fast. The effect of exercise before, during, and after dive on bubble formation is still controversial...
  28. Jallul S, Osman A, el Masry W. Cerebro-spinal decompression sickness: report of two cases. Spinal Cord. 2007;45:116-20 pubmed
    ..Two case reports...
  29. Butler B, Little T, Sothern R, Smolensky M. Circadian study of decompression sickness symptoms and response-associated variables in rats. Chronobiol Int. 2010;27:138-60 pubmed publisher
    In order to study circadian rhythms and decompression sickness (DCS), we determined: 1) the baseline circadian time structure in noncompressed rats of potential response variables to compression/decompression (C/D), and 2) whether rats ..
  30. Tourigny P, Hall C. Diagnosis and management of environmental thoracic emergencies. Emerg Med Clin North Am. 2012;30:501-28, x pubmed publisher
    ..Current treatment paradigms and controversies within these regimens are discussed...
  31. Moen G, Specht K, Taxt T, Sundal E, Grøning M, Thorsen E, et al. Cerebral diffusion and perfusion deficits in North Sea divers. Acta Radiol. 2010;51:1050-8 pubmed publisher
    ..Microvascular dysfunction due to gas microembolism and exposure to hyperoxia are possible mechanisms, which may result in cerebral diffusion and perfusion deficits...
  32. Pontier J, Blatteau J, Vallee N. Blood platelet count and severity of decompression sickness in rats after a provocative dive. Aviat Space Environ Med. 2008;79:761-4 pubmed
    ..Adherence and aggregation of platelets to the bubble surface has been demonstrated in severe decompression sickness (DCS)...
  33. Irgens A, Grønning M, Troland K, Sundal E, Nyland H, Thorsen E. Reduced health-related quality of life in former North Sea divers is associated with decompression sickness. Occup Med (Lond). 2007;57:349-54 pubmed
    ..Diving is associated with long-term effects on several organ systems...
  34. Arieli R, Boaron E, Arieli Y, Abramovich A, Katsenelson K. Oxygen pretreatment as protection against decompression sickness in rats: pressure and time necessary for hypothesized denucleation and renucleation. Eur J Appl Physiol. 2011;111:997-1005 pubmed publisher
    Pretreatment with HBO at 300-500 kPa for 20 min reduced the incidence of decompression sickness (DCS) in a rat model...
  35. Madden L, Laden G. Gas bubbles may not be the underlying cause of decompression illness - The at-depth endothelial dysfunction hypothesis. Med Hypotheses. 2009;72:389-92 pubmed publisher
    ..Furthermore, this damage may manifest itself in the release of endothelial membrane fragments (microparticles)...
  36. Bigley N, Perymon H, Bowman G, Hull B, Stills H, Henderson R. Inflammatory cytokines and cell adhesion molecules in a rat model of decompression sickness. J Interferon Cytokine Res. 2008;28:55-63 pubmed publisher
    To characterize early blood and tissue markers predictive of decompression sickness (DCS), this study focused on identifying changes in inflammatory mediators during the 24-h period immediately following compression-decompression of ..
  37. Newton H, Padilla W, Burkart J, Pearl D. Neurological manifestations of decompression illness in recreational divers - the Cozumel experience. Undersea Hyperb Med. 2007;34:349-57 pubmed
    ..001). Neurological manifestations are common in recreational divers treated for DCI. Neurological DCI and paresthesias are more likely to occur in younger and less experienced divers...
  38. Mahon R, Dainer H, Nelson J. Decompression sickness in a swine model: isobaric denitrogenation and perfluorocarbon at depth. Aviat Space Environ Med. 2006;77:8-12 pubmed
    Disabled submarine survivors could achieve inert gas tissue saturation likely to cause severe decompression sickness (DCS) on surfacing. This risk increases with time and depth of exposure...
  39. Fahlman A, Schmidt A, Jones D, Bostrom B, Handrich Y. To what extent might N2 limit dive performance in king penguins?. J Exp Biol. 2007;210:3344-55 pubmed
    A mathematical model was used to explore if elevated levels of N2, and risk of decompression sickness (DCS), could limit dive performance (duration and depth) in king penguins (Aptenodytes patagonicus)...
  40. Montcalm Smith E, Caviness J, Chen Y, McCarron R. Stress biomarkers in a rat model of decompression sickness. Aviat Space Environ Med. 2007;78:87-93 pubmed
    ..stress responses, and inflammatory reactions may all contribute to pathogenic mechanisms associated with decompression sickness (DCS). Currently, there are no biomarkers for DCS...
  41. Blatteau J, Barre S, Pascual A, Castagna O, Abraini J, Risso J, et al. Protective effects of fluoxetine on decompression sickness in mice. PLoS ONE. 2012;7:e49069 pubmed publisher
    Massive bubble formation after diving can lead to decompression sickness (DCS) that can result in central nervous system disorders or even death...
  42. Møllerløkken A, Gaustad S, Havnes M, Gutvik C, Hjelde A, Wisløff U, et al. Venous gas embolism as a predictive tool for improving CNS decompression safety. Eur J Appl Physiol. 2012;112:401-9 pubmed publisher
    A key process in the pathophysiological steps leading to decompression sickness (DCS) is the formation of inert gas bubbles...
  43. Hyldegaard O, Jensen T. Effect of heliox, oxygen and air breathing on helium bubbles after heliox diving. Undersea Hyperb Med. 2007;34:107-22 pubmed
    ..most animals survived during the observation period but with air breathing, most animals died of decompression sickness regardless of whether the surrounding atmosphere was helium or air...
  44. Jepson P, Deaville R, Patterson I, Pocknell A, Ross H, Baker J, et al. Acute and chronic gas bubble lesions in cetaceans stranded in the United Kingdom. Vet Pathol. 2005;42:291-305 pubmed
  45. Brubakk A, Arntzen A, Wienke B, Koteng S. Decompression profile and bubble formation after dives with surface decompression: experimental support for a dual phase model of decompression. Undersea Hyperb Med. 2003;30:181-93 pubmed
  46. Neuman T. Arterial gas embolism and decompression sickness. News Physiol Sci. 2002;17:77-81 pubmed
    b>Decompression sickness occurs when a sufficiently large gas phase forms within the tissues of the body after a reduction in ambient pressure...
  47. Kot J, Sićko Z. Delayed treatment of bubble related illness in diving--review of standard protocol. Int Marit Health. 2004;55:103-20 pubmed
    ..Other drugs (aspirin, lidocaine, heparin, steroids, calcium channel blockers, antioxidants) should still be treated as an option considered by clinician, but without strong evidences from clinical studies...
  48. Pilmanis A, Petropoulos L, Kannan N, Webb J. Decompression sickness risk model: development and validation by 150 prospective hypobaric exposures. Aviat Space Environ Med. 2004;75:749-59 pubmed
    High altitude exposure has an inherent risk of altitude decompression sickness (DCS). A predictive DCS model was needed to reduce operational risk...
  49. Piantadosi C, Thalmann E. Pathology: whales, sonar and decompression sickness. Nature. 2004;428:1 p following 716; discussion 2 p following 716 pubmed
    ..suggest that a peculiar gas-forming disease afflicting some stranded cetaceans could be a type of decompression sickness (DCS) resulting from exposure to mid-range sonar...
  50. Hagberg M, Ornhagen H. Incidence and risk factors for symptoms of decompression sickness among male and female dive masters and instructors--a retrospective cohort study. Undersea Hyperb Med. 2003;30:93-102 pubmed
    The aim was to determine the incidence of symptoms of decompression sickness (DCS) in dive masters and instructors in relation to number of dives and possible risk factors.
  51. Huang K, Wu C, Chen Y, Kang B, Lin Y. Heat stress attenuates air bubble-induced acute lung injury: a novel mechanism of diving acclimatization. J Appl Physiol (1985). 2003;94:1485-90 pubmed
    Diving acclimatization refers to a reduced susceptibility to acute decompression sickness (DCS) in individuals undergoing repeated compression-decompression cycles...
  52. Blogg S, Loveman G, Seddon F, Woodger N, Koch A, Reuter M, et al. Magnetic resonance imaging and neuropathology findings in the goat nervous system following hyperbaric exposures. Eur Neurol. 2004;52:18-28 pubmed
    ..Thirty goats were exposed to various dive profiles over a period of 5 years, with 17 experiencing decompression sickness (DCS). Brains were scanned using magnetic resonance (MR) imaging techniques...
  53. Jepson P, Arbelo M, Deaville R, Patterson I, Castro P, Baker J, et al. Gas-bubble lesions in stranded cetaceans. Nature. 2003;425:575-6 pubmed