By: Iveth García Tovar.
Scuba Diving implicates a lot of risks: environmental
exposure problems and dangers of marine life, panic reactions and other
psychological problems, and all of the secondary alterations to dysbarism. On
the last one, there are included barotrauma (because of the direct effect of
pressure), air embolism (penetration of air bubbles into the systemic
circulation through the ruptured pulmonary veins) and decompression sickness
include.
Decompression sickness is a multisystem disorder
resulting from the release of inert gas in solution with the consequent
formation of gas bubbles in the blood and tissue level, which occurs when the
environmental pressure drops abruptly. In most cases the inert gas absorbed in
the tissues is nitrogen. The classification of decompression sickness is based
on the severity of symptoms and the most committed bodies as appropriate:
Type 1: mild: cutaneous manifestations, skeletal
muscle and lymph.
Type 2: severe: neurological and pulmonary manifestations,
shock and visceral abnormalities. In some cases, despite the formation of gas
bubbles in blood as demonstrated by ultrasonographic techniques; no immediate
clinical manifestations are develop or they are very subtle. However, repeated
events may originate long-term complications resulting from the presence of
foci of tissue destruction.
A proper and quick handling is definite to prevent
death and / or to prevent or mitigate the potential consequences of
invalidating character. The main therapeutic pillar is hyperbaric treatment.
Other measures are complementary and symptomatic: hydration, pain relief,
correction of electrolyte disorders, and treatment of states of shock.
Decompression sickness in diving is a condition that involves multiple organ
systems, depending on the most affected site it will be its clinical
presentation. It can play critical states where the Nervous Central System is
one of the most committed and it can even lead to death. Both its appearance
and its complications can be prevented with adequate knowledge of the
pathogenic mechanisms background.
References: Buhlmann AA: Decompression sickness 01 the spinal
cord, results of early and of late treatmen Schweiz Med Wochnsch 1985. Jun 8:
115 (23): 796-800
