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Arterial gas embolism during pressure tolerance testing in a hyperbaric chamber: a report of two cases.

Authors
  • Buschmann, D Kim
Type
Published Article
Journal
Aviation Space and Environmental Medicine
Publisher
Aerospace Medical Association
Publication Date
Dec 01, 2010
Volume
81
Issue
12
Pages
1133–1136
Identifiers
PMID: 21197859
Source
Medline
License
Unknown

Abstract

This is a report of two cases of arterial gas embolism (AGE) occurring during the course of routine pressure tolerance testing (PTT) of Canadian Forces divers in a dry hyperbaric chamber. PTT is used by many military organizations as a means to determine whether divers can sustain a hyperbaric challenge similar to that to which they will be exposed during their diving duties. Problems arising from such testing are usually limited to issues of equalization and minor otic barotraumas. Incidents of AGE resulting from hyperbaric chamber exposures in general are very unusual. The incidents reported here are the first such cases arising in military divers during PTT to be reported in the extant literature. In one case a potential precipitating pulmonary lesion was identified during post-event chest imaging. In the other case, while presenting with all the usual hallmarks of an AGE, no predisposing pulmonary lesion was identified. Ascent rates were within the limits considered acceptable by the Canadian Forces for PTT. The cases are useful in examining the pathophysiologic mechanisms underlying pulmonary barotrauma and AGE, and raise questions as to the appropriate screening procedures for military divers in this regard.

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