INTRODUCTION: Patent foramen ovale (PFO) is a risk factor of decompression sickness (DCS). However, data on risk stratification of divers with a PFO are sparse. This study sought to evaluate the risk of neurological DCS (DCSneuro), based on the presence and grade of a right-to-left shunt (RLS). METHODS: A total of 640 divers were screened for a RLS using TCD between 1/2006 and 4/2017. RLS was graded as low, medium, or high grade with two subgroups - after a Valsalva maneuver or at rest. Divers were questioned about their DCS history. Survival analysis techniques were used to assess risk factors for unprovoked DCS. RESULTS: A RLS was found in 258 divers (40.3 %). 44 (17.1 %) divers with a RLS experienced DCSneuro compared to 5 (1.3 %) divers without a RLS (p <0.001). The proportion of DCSneuro increased from 4.6 % in the low-grade RLS subgroup to 57.1 % in the subgroup with high-grade RLS at rest. The hazard ratio for DCSneuro and RLS was11.806 (p <0.001). CONCLUSIONS: Divers with a RLS had a higher risk of DCSneuro and the risk increased with RLS grade. We suggest that TCD is an appropriate method for RLS screening and risk stratification in divers (Tab. 4, Fig. 2, Ref. 29).
- MeSH
- Decompression Sickness * epidemiology etiology classification physiopathology MeSH
- Adult MeSH
- Foramen Ovale, Patent complications MeSH
- Humans MeSH
- Mass Screening methods MeSH
- Diving * adverse effects MeSH
- Risk Factors MeSH
- Statistics as Topic MeSH
- Persistent Fetal Circulation Syndrome diagnosis epidemiology complications MeSH
- Ultrasonography, Doppler, Transcranial MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Publication type
- Clinical Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Keywords
- radionekróza,
- MeSH
- Central Nervous System pathology MeSH
- Decompression Sickness diagnosis etiology classification physiopathology prevention & control therapy MeSH
- Diabetic Foot therapy MeSH
- Child MeSH
- Adult MeSH
- Fasciitis, Necrotizing etiology classification pathology MeSH
- Wound Healing MeSH
- Hyperbaric Oxygenation * standards MeSH
- Soft Tissue Infections etiology classification complications microbiology pathology MeSH
- Ischemia therapy MeSH
- Clinical Studies as Topic MeSH
- Clostridium Infections pathology MeSH
- Extremities injuries MeSH
- Humans MeSH
- Urinary Bladder radiation effects MeSH
- Brain pathology MeSH
- Myocardium pathology MeSH
- Tumor Hypoxia MeSH
- Necrosis etiology therapy MeSH
- Neuroblastoma therapy MeSH
- Osteoradionecrosis MeSH
- Carbon Monoxide Poisoning history diagnosis epidemiology etiology complications mortality physiopathology pathology prevention & control therapy MeSH
- Oxygen Inhalation Therapy classification instrumentation MeSH
- Postoperative Complications etiology therapy MeSH
- Auditory Perceptual Disorders etiology therapy MeSH
- Hearing Disorders classification therapy MeSH
- Diving adverse effects MeSH
- Surveys and Questionnaires MeSH
- Radiation Injuries physiopathology pathology MeSH
- Wounds and Injuries classification physiopathology pathology therapy MeSH
- Rectum radiation effects MeSH
- Practice Guidelines as Topic MeSH
- Tinnitus therapy MeSH
- Radiation Tolerance MeSH
- Blood Gas Monitoring, Transcutaneous MeSH
- Accidents MeSH
- Ulcer classification physiopathology therapy MeSH
- Treatment Outcome MeSH
- Embolism, Air diagnosis etiology classification physiopathology therapy MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- Review MeSH
- Keywords
- intoxikace kyslíkem,
- MeSH
- Barotrauma etiology physiopathology MeSH
- Decompression Sickness * etiology classification physiopathology MeSH
- Oxygen administration & dosage poisoning MeSH
- Humans MeSH
- Inert Gas Narcosis etiology physiopathology MeSH
- High Pressure Neurological Syndrome etiology physiopathology MeSH
- Diving * physiology adverse effects MeSH
- Embolism, Air etiology physiopathology MeSH
- Check Tag
- Humans MeSH
V príspevku sa autori zamerali na etiológiu a patogenézu neurologickej formy dekompresnej choroby rekreačných potápačov, ako aj deskripciu jej klinickej symptomatológie. Súčasťou príspevku sú tri klinické kazuistiky, medicínsky posudzované prvým autorom príspevku, súdnym znalcom v odvetví hyperbarickej a potápačskej medicíny.
Authors of the paper focused on etiology and pathogenesis of neurologic form of decompression sickness in recreational divers, and its clinical symptomatology as well. Simultaneously, three case reports are presented, which were medically analysed by the first author of the paper, the state expert on hyperbaric and diving medicine.
- Keywords
- rekreační potápění, neurologická forma dekompresní nemoci,
- MeSH
- Time Factors MeSH
- Decompression Sickness * etiology classification physiopathology therapy MeSH
- Adult MeSH
- Hyperbaric Oxygenation MeSH
- Spinal Cord Compression etiology physiopathology MeSH
- Quadriplegia MeSH
- Middle Aged MeSH
- Humans MeSH
- Central Nervous System Diseases * etiology physiopathology therapy MeSH
- Spinal Cord Diseases etiology physiopathology therapy MeSH
- Brain Diseases etiology physiopathology MeSH
- Peripheral Nervous System Diseases etiology physiopathology therapy MeSH
- High Pressure Neurological Syndrome etiology physiopathology therapy MeSH
- Paraparesis MeSH
- Diving * adverse effects MeSH
- Accidents MeSH
- Ear, Inner injuries MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Decompression Sickness classification physiopathology therapy MeSH
- Craniocerebral Trauma * epidemiology classification physiopathology therapy MeSH
- Humans MeSH
- Electric Injuries physiopathology therapy MeSH
- Spinal Cord Injuries diagnosis epidemiology physiopathology therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
