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>> Recompression works because of the pharmacological effects of oxygen as
>> opposed to the mechanical effects of pressure.
>What about all the successful air-only IWR cases, usually performed in
><20m max? Would all of these have been better-off breathing O2 on the
>surface? Is it possible that, if dealt with within a few minutes of
>symptoms, the hydrostatic pressure DOES matter? (Not a pointed
>question...honest...)
What about them? How many successfull IWR on air only compared to HBO (IW
or IC) are there? Well to find out we would need to take 15-20 healthy
age/weight etc matched divers, bend them and treat some with HBO and some
with pressure only and test for DCI. But wait! It's been done (more or
less). Submarine escape trainees who suffer DCI can be treated effectively
and often completely by a single 6 BAR recompression provided it is
initiated immediately. Indeed placing the recompression chamber at the top
of a submarine escape training tank (instead of having it at ground level)
to shorten the time between DCI first being recognised and treatment being
started has itself reduced the mortality and morbidity of DCI in this group
of people [Van Genderen & Waite 1968]. Once this time "window" is past
however, multiple treatments with hyperbaric O2 are required to treat DCI.
Thus, although reducing bubble size is important, 2.8 BAR of O2 is affecting
some other specific processes initiated by DCI. Whatever this process is,
it has been shown to be further alleviated by other therapies adjunctive to,
or in place of, hyperbaric O2. Many investigations into such treatments
have been undertaken [Catron et al 1984; Dutka 1985; Evans et al 1984; Evans
et al 1989;
Kochanek et al 1987b; Lindsberg et al 1991; McDermott et al 1990; Menasche
et al
1985; Spiess et al 1988a] and some hyperbaric practitioners are already
advocating use of agents such as lignocaine as an adjunct to hyperbaric O2
[Drewry & Gorman 1992; Dutka et al 1992a; Dutka 1990] even though the exact
mode of action is unknown.
Aloha to you also and safe IWR (air or Oxygen)
/rat
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
shelps@ac*.ma*.ad*.ed*.au*|Stephen Helps PhD Ack! ___/|
FAX (08)232-3283 |Anaesthesia & Intensive Care \O.o|
Voice (08)224-5495 |University of Adelaide =(___)=
|ADELAIDE, 5005, South Australia U
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"It's not denial. I'm just very selective about what I accept as reality."
--- Calvin ("Calvin and Hobbes")
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