Chest
Clinical Investigations: Water SportsRisk Factors for Pulmonary Barotrauma in Divers
Section snippets
Materials and Methods
We studied 15 PBT patients, who had been referred to our department consecutively, and compared them with 15 patients who suffered neurologic decompression sickness (DCS type 2). There were 11 male and 4 female divers in both groups. Seven patients in the PBT group were current smokers vs nine in the DCS group (Table 1). Among the PBT patients, there were three military divers, one police diver, one commercial diver, seven sports divers, two submarine escape tank trainees, and one hyperbaric
Results
PBT patients were younger than DCS patients (25.2 vs 27.9 years; p=0.07). No significant differences between groups were found with respect to body height (p=0.51) or weight (p = 0.54) (Table 1).
Among the patients who suffered PBT from diving, there were 13 cases of arterial gas embolism, 1 case of pneumothorax, and 1 case of mediastinal emphysema. In 3 of 13 cases, arterial gas embolism was accompanied by mediastinal emphysema and pneumothorax. All but one were first incidents; one female
Discussion
PBT in diving refers to tissue injury resulting from expanding gas during ascent which is not able to escape through the airways, due to Boyle's law, which states that there is an inverse relationship between the volume of a gas and the pressure applied.7 Breath-holding during rapid ascent and pulmonary diseases, particularly conditions that predispose to gas trapping, may contribute to the risk of PBT. Bullous diseases,13 asthma,14 and pleural adhesions15 have been described as possible causes
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