Vascular hyperpermeability in pulmonary decompression illness: 'The chokes'.

Vascular hyperpermeability in pulmonary decompression illness: 'The chokes'.

Abstract/OtherAbstract:

Decompression illness (DCI) develops during or after diving. Pulmonary decompression illness ('Chokes') is rarely seen because the affected individual usually dies in the water. We encountered a rare and interesting case. A 60-year-old man complained of leg pain after diving. Despite rapid transfer to a nearby hospital, advanced respiratory failure and shock had set in. He was then transferred to our hospital for hyperbaric oxygen therapy (HBOT). On account of his poor general condition, we initially treated him in the intensive care unit without HBOT, where he showed extreme hyperpermeability and a high level of serum procalcitonin (PCT; 20.24 ng/mL). Despite large-volume fluid therapy, severe intravascular dehydration and shock status remained. We assume that the injured endothelial cells induced vascular hyperpermeability and increased levels of inflammatory cytokines leading to the high serum PCT level. PCT might be a useful stress marker of endothelial damage and severity in DCI, including Chokes.

Authors:

Yutaka Kondo; Shinya Shiohira; Kota Kamizato; Koji Teruya; Tatsuya Fuchigami; Manabu Kakinohana; Ichiro Kukita

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Publication Detail:

Type:  Journal Article    

Journal Detail:

Title:  Emergency medicine Australasia : EMA     Volume:  24     ISSN:  1742-6723     ISO Abbreviation:  Emerg Med Australas     Publication Date:  2012 Aug 

Date Detail:

Created Date:  2012-08-06     Completed Date:  -     Revised Date:  -    

Medline Journal Info:

Nlm Unique ID:  101199824     Medline TA:  Emerg Med Australas     Country:  Australia    

Other Details:

Languages:  eng     Pagination:  460-2     Citation Subset:  IM    

Copyright Information:

© 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Affiliation:

Department of Emergency Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.

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