Guiding principles in choosing a therapeutic table for DCI hyperbaric therapy.
Hyperbaric therapy is the basis of treatment for pervasive development disorders. For this reason, the choice of the right therapeutic table for each case is critical. Above all, the delay in recompression time with respect to the first symptoms and to the severity of the case must be considered. In our experience, the use of low-pressure oxygen tables resolves almost all cases if recompression takes place within a short time. When recompression is possible almost immediately, the mechanical effect of reduction on bubble volume due to pressure is of remarkable importance. In these cases, high-pressure tables can be considered. These tables can also be used in severe spinal-cord decompression sickness. The preferred breathing mixture is still disputed. Heliox seems to be favored because it causes fewer problems during the recompression of divers, and above all, because nitrox can cause narcosis and contributes nitrogen. Saturation treatment should be avoided or at least used only in special cases. In cases of arterial gas embolism cerebral injury, it is recommended to start with an initial 6 ATA recompression only if the time between symptom onset and the beginning of recompression is less than a few hours.
Antonelli
C
C
Unit of Diving and Hyperbaric Medicine, Misericordia Hospital, Via Senese, Grosseto, Italy. m.brauzzi@usl9.toscana.it
Franchi
F
F
Della Marta
M E
ME
Carinci
A
A
Sbrana
G
G
Tanasi
P
P
De Fina
L
L
Brauzzi
M
M
D000328:Adult; D000465:Algorithms; D002448:Cell Adhesion / Q000187:drug effects; D003665:Decompression Sickness / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D004618:Embolism, Air / Q000628:therapy; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology; D005260:Female; D006371:Helium / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D000860:Hypoxia / Q000209:etiology / Q000517:prevention & control; D007222:Inert Gas Narcosis / Q000209:etiology / Q000517:prevention & control; D007962:Leukocytes / Q000187:drug effects / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D010100:Oxygen / Q000008:administration & dosage* / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D015427:Reperfusion Injury / Q000209:etiology / Q000517:prevention & control; D013116:Spinal Cord / Q000098:blood supply; D013117:Spinal Cord Compression / Q000150:complications / Q000628:therapy; D016896:Treatment Outcome
D006371:Helium; C041364:nitrox; C038949:heliox; D009584:Nitrogen; D010100:Oxygen