Blake Denise F, Crowe Melissa, Lindsay Daniel, Turk Richard, Mitchell Simon J, Pollock Neal W
Emergency Department, Townsville University Hospital, Townsville, Queensland, Australia.
Marine Biology and Aquaculture, James Cook University, Townsville, Queensland, Australia.
Diving Hyperb Med. 2024 Dec 20;54(4):308-319. doi: 10.28920/dhm54.4.308-319.
Hyperbaric oxygen treatment (HBOT) is considered definitive treatment for decompression illness. Delay to HBOT may be due to dive site remoteness and limited facility availability. Review of cases may help identify factors contributing to clinical outcomes.
Injured divers treated in Townsville from November 2003 through December 2018 were identified. Information on demographics, initial disease severity, time to symptom onset post-dive, time to pre-HBOT oxygen therapy (in-water recompression or normobaric), time to HBOT, and clinical outcome was reviewed. Data were reported as median (interquartile range [IQR]) with Kruskal-Wallis and chi-square tests used to evaluate group differences. Significance was accepted at P < 0.05.
A total of 306 divers (184 males, 122 females) were included with a median age of 29 (IQR 24, 35) years. Most divers had mild initial disease severity (n = 216, 70%). Time to symptom onset was 60 (10, 360) min, time to pre-HBOT oxygen therapy was 4:00 (00:30, 24:27) h:min, and time to start of HBOT was 38:51 (22:11, 69:15) h:min. Most divers (93%) had a good (no residual or minor residual symptoms) outcome and no treated diver died. Higher initial disease severity was significantly associated with shorter times to symptom onset, oxygen therapy, and HBOT, and with worse outcomes. The paucity of cases receiving HBOT with minimal delay precluded meaningful evaluation of the effect of delay to HBOT.
Most divers had mild initial disease severity and a good outcome. Higher initial disease severity accelerated the speed of care obtained and was the only factor associated with poorer outcome.
高压氧治疗（HBOT）被认为是减压病的确定性治疗方法。延迟进行HBOT可能是由于潜水地点偏远以及可用设施有限。病例回顾可能有助于确定影响临床结果的因素。
确定了2003年11月至2018年12月在汤斯维尔接受治疗的受伤潜水员。回顾了有关人口统计学、初始疾病严重程度、潜水后症状出现时间、HBOT前氧疗时间（水下再压缩或常压）、HBOT开始时间和临床结果的信息。数据报告为中位数（四分位间距[IQR]），使用Kruskal-Wallis检验和卡方检验评估组间差异。P < 0.05时具有统计学意义。
共纳入306名潜水员（184名男性，122名女性），中位年龄为29岁（IQR 24，35）。大多数潜水员初始疾病严重程度较轻（n = 216，70%）。症状出现时间为60（10，360）分钟，HBOT前氧疗时间为4:00（00:30，24:27）小时:分钟，HBOT开始时间为38:51（22:11，69:15）小时:分钟。大多数潜水员（93%）预后良好（无残留或轻微残留症状），且无接受治疗的潜水员死亡。初始疾病严重程度较高与症状出现时间、氧疗时间和HBOT时间较短显著相关，且与较差的预后相关。因延迟进行HBOT的病例极少，无法对延迟HBOT的影响进行有意义的评估。
大多数潜水员初始疾病严重程度较轻且预后良好。初始疾病严重程度较高加快了获得治疗的速度，是与较差预后相关的唯一因素。
