Evaluation and management of decompression illness--an intensivist's perspective.
Decompression illness (DCI) is becoming more prevalent as more people engage in activities involving extreme pressure environments such as recreational scuba-diving. Rapid diagnosis and treatment offer these patients the best chance of survival with minimal sequelae. It is thus important that critical care physicians are able to evaluate and diagnose the signs and symptoms of DCI. The cornerstones of current treatment include the administration of hyperbaric oxygen and adjunctive therapies such as hydration and medications. However, managing patients in a hyperbaric environment does present additional challenges with respect to the particular demands of critical care medicine in an altered pressure environment. This article reviews the underlying pathophysiology, clinical presentation and therapeutic options available to treat DCI, from the intensivist's perspective.
Tetzlaff
Kay
K
1st Department of Medicine, Christian-Albrechts-University of Kiel, Schittenhelmstrasse 12, 24105, Kiel, Germany. Kay.Tetzlaff@bc.boehringer-ingelheim.com.|Clinical Research (Respiratory), Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 , Biberach an der Riss, Germany. Kay.Tetzlaff@bc.boehringer-ingelheim.com.
Shank
Erik S
ES
Department of Anaesthesia and Critical Care, Massachusetts General Hospital, Boston, MA 02114, USA.
Muth
Claus M
CM
Department of Anaesthesiology, Section of Pathophysiology and Process Development, University of Ulm, Parkstrasse 11, 89073 , Ulm, Germany.
D000818:Animals; D003422:Critical Care; D003665:Decompression Sickness / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000379:methods*; D012720:Severity of Illness Index