Perez Michael Fm, Ongkeko Perez Janet V, Serrano April R, Andal Maravic P, Aldover Maria Cc
Saint Patrick's Hospital Medical Centre, SPHMC-HH, Lopez Jaena Street, Batangas City, Philippines,
Saint Patrick's Hospital Medical Centre, SPHMC-HH, Philippines.
Diving Hyperb Med. 2017 Dec;47(4):257-259. doi: 10.28920/dhm47.4.257-259.
Arterial gas embolism is a catastrophic event. Bubbles in the arterial circulation may lodge in the brain and cause infarction in the affected area and/or in a coronary vessel causing acute myocardial ischaemia. There is no well-defined window of time beyond which a response to hyperbaric oxygen is not expected. Major improvement may occur if the patient is treated as soon as possible, but is less likely in divers with severe decompression illness who have delayed intervention. We report on a 51-year-old, male rebreather diver who suffered loss of consciousness and cardiovascular collapse within minutes of a 30-metre deep dive at a remote Micronesian dive site. Recompression treatment did not start for six days for reasons to be presented, during which time he remained deeply comatose, cardiovascularly unstable and intubated on ventilator support. Despite this, following aggressive hyperbaric treatment over many days he made a functional recovery. At one year post injury, he is leading a functional life but has not returned to his previous occupation as a diver and suffers from moderately severe tinnitus and impaired right ear hearing and occasional mild speech problems. He is undertaking a number of on-line courses with a view to re-employment.
动脉气体栓塞是一种灾难性事件。动脉循环中的气泡可能会滞留在大脑中，导致受影响区域梗死和/或滞留在冠状动脉中，引起急性心肌缺血。对于高压氧治疗不存在明确的无效时间窗。如果患者尽早接受治疗，可能会有显著改善，但对于延迟干预的重度减压病潜水员来说，改善的可能性较小。我们报告一例51岁男性循环呼吸器潜水员，在密克罗尼西亚一个偏远潜水地点进行30米深潜水后几分钟内出现意识丧失和心血管衰竭。由于某些原因，六天后才开始进行再加压治疗，在此期间他一直深度昏迷，心血管不稳定，靠呼吸机支持并插管。尽管如此，经过多日积极的高压治疗后，他实现了功能恢复。在事发一年后，他能正常生活，但没有回到之前潜水员的职业岗位，患有中度严重耳鸣、右耳听力受损以及偶尔出现轻度言语问题。他正在参加一些在线课程，以期重新就业。
