Undersea Hyperbar M
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Undersea Hyperbar M · Jul 2013
Case ReportsCase report: clearance to dive for a naval candidate with family history of malignant hyperthermia.
A 20-year-old male military recruit who presented for a screening physical for U.S.Naval Diving Duty was found to have family history significant for malignant hyperthermia. He had never been exposed to anesthesia, a trigger for the condition, and had not undergone testing. Medical history was otherwise unremarkable, and the patient was cleared for diving. ⋯ Individuals with presumed or proven malignant hyperthermia susceptibility seeking activity clearance should be given precautions and undergo careful questioning for history of heat- or exercise-related illness. If negative, it seems reasonable to allow the patient participation in recreational or technical diving.
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Undersea Hyperbar M · May 2013
The free radical scavenger, edaravone, ameliorates delayed neuropsychological sequelae after acute carbon monoxide poisoning in rabbits.
The mechanism underlying delayed neuropsychological sequelae (DNS) after acute carbon monoxide (CO) poisoning is unclear. There are no effective treatments for DNS. As part of a new generation of antioxidants, edaravone has been reported to improve clinical outcomes in patients exhibiting ischemic strokes. There has been little data about edaravone in relationship to DNS prevention and treatment. We hypothesized that edaravone could ameliorate DNS: Here we test that hypothesis in rabbits ⋯ Our present research demonstrates that edaravone could ameliorate DNS after acute carbon monoxide poisoning in rabbits. These results suggest free radicals could be involved in the underlying mechanisms of DNS. Furthermore, brain MRS shows promise as a tool for early diagnosis for DNS.
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Undersea Hyperbar M · Mar 2013
Randomized Controlled TrialA prospective trial of hyperbaric oxygen for chronic sequelae after brain injury (HYBOBI).
Some practitioners advocate hyperbaric oxygen (HBO2) for sequelae following brain injury. This study assessed recruitment, tolerance and safety in preparation for a randomized clinical trial. ⋯ Conducting an HBO2 clinical trial in this population was feasible. Although many participants reported improvement, the lack of concurrent controls limits the strength of inferences from this trial, especially considering lack of change in standardized testing. The clinical relevance of neuroimaging changes is unknown. The findings of this study may indicate a need for caution when considering the broad application of HBO2 more than one year after brain injury due to stroke, severe TBI and anoxia, until there is more compelling evidence from carefully designed sham-controlled, blinded clinical trials.
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Undersea Hyperbar M · Mar 2013
Physical exercise might influence the risk of oxygen-induced acute neurotoxicity.
Hyperoxia can induce acute neurotoxicity with generalized seizures. Hyperoxia-induced reduction in cerebral blood flow velocity (CBFV) might be protective. It is unclear whether dynamic exercise during hyperoxia can overcome CBFV-reduction and thus possibly increase the risk of neurotoxicity. ⋯ Physical exercise overrules the decrease in CBFV during hyperoxia and leads to even higher CBFV-increases with increasing pO2. A tendency towards CO2 retainment with elevated PetCOz may be causative and thus heighten the risk of oxygen-induced neurotoxicity.
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Undersea Hyperbar M · Jan 2013
Case ReportsTreatment of carbon monoxide poisoning with hyperbaric oxygen and therapeutic hypothermia.
We present a preliminary case report series of severe, acute carbon monoxide poisoning in which both hyperbaric oxygen (HBO2) and therapeutic hypothermia (TH) were used to ameliorate neurological sequelae. Carbon monoxide poisoning is a standard indication for HBO2. While typically used postcardiac arrest, TH has been used for other types of hypoxic-ischemic brain injury. ⋯ One patient sustained severe, diffuse brain injury yet made a dramatic neurological recovery with only minor limitations in higher order memory and attention. No patient left the hospital with other end organ damage including cardiac dysfunction. To our knowledge, these are the first reported cases of the use of both HBO2 and TH to treat severe, acute carbon monoxide poisoning.