![]() ![]() The indirect effects are mediated by an inflammatory response with activation of complement and coagulation factors and platelets. The direct effects are represented by the mechanical obstruction of a vein or an artery. These bubbles can have direct and indirect effects. When a critical amount of nitrogen dissolves in the tissues, a rapid decrease in pressure causes the dissolved nitrogen to return to its gas form while still in the blood or tissues, causing bubbles to form. The absorption depends on the gradient tissue alveolus and on the blood–issue solubility ratio. As the ambient pressure increases, the air pressure of the inert gas (generally N 2) is greater than its arterial pressure, which causes the tissues to absorb this inert gas until the balance between the two pressures is reached. In this review, we schematically introduce and define each one of them, and then briefly summarize their main characteristics, with a review of their pathophysiology, clinical manifestations, and therapy.ĭecompression illness is a multisystem disease caused by the formation of gas bubbles in the blood and tissues during or after a decrease in environmental pressure (decompression). Overall, five clinical pictures can occur: decompression illness, barotrauma, gas embolism, inert gas narcosis, and oxygen toxicity. Manifestations of dysbarism range from itching and minor pain to neurological symptoms, cardiac collapse, and death. In the first case, they will develop when the pressure increases to the point of overcoming the adaptive mechanisms of the organism in the second case, they will develop when the decompression time is too short for the adaptive mechanisms to be efficient. Furthermore, dysbarism can arise from iatrogenic causes unrelated to decompression, such as non-invasive ventilation and invasive mechanical ventilation.ĭifferent pathologies can occur when the body is subjected to a pressure higher than the atmospheric one or when, after being subjected to it, it returns to normal pressure (decompression) too quickly. Nevertheless, it still represents a medical emergency that is not widely researched.Īlthough the most common cause of dysbarism is underwater diving, it can also be associated with aviation and space exploration, as well as compressed air tunnel and caisson work. The risk of developing dysbarism is higher than in the past decades, due to the advancement of technology and the spread of certain sports practices. ![]() Such an approach is critical for the effective treatment of patients in a hostile environment, or treatment in the emergency room after exposure to extreme physical or environmental factors.ĭysbarism is a general term which includes the signs and symptoms that can manifest when the body is subject to an increase or a decrease in the atmospheric pressure which occurs either at a rate or duration exceeding the capacity of the body to adapt safely. The last three parts will be dedicated to gas embolism, inert gas narcosis, and oxygen toxicity. In the next part, we will review the barotrauma, compression, and decompression. We will first introduce the two forms of decompression sickness. We will then review the clinical manifestations and illustrate some hints of therapy. Overall, four clinical pictures can occur: decompression illness, barotrauma, inert gas narcosis, and oxygen toxicity. ![]() Starting from the underlying physical laws, we will deal with the pathologies that can develop in the most frequently affected areas of the body, as the atmospheric pressure varies when acclimatization fails. In the following review, we take dysbarisms into account for our analysis. Dysbarism is a general term which includes the signs and symptoms that can manifest when the body is subject to an increase or a decrease in the atmospheric pressure which occurs either at a rate or duration exceeding the capacity of the body to adapt safely. ![]()
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