BACKGROUND:
Post-decompression shock with plasma volume deficit is a very rare event that has been observed under extreme conditions of hypobaric and hyperbaric exposure in aviators and professional divers.
CASE REPORT:
We report a case of severe hypovolemic shock due to extravasation of plasma in a recreational scuba diver presenting with inner ear decompression sickness. Impaired endothelial function can lead to capillary leak with hemoconcentration and hypotension in severe cases. This report suggests that decompression-induced circulating bubbles may have triggered the endothelial damage, activating the classic inflammatory pathway of increased vascular permeability.
CONCLUSION:
This observation highlights the need for an accurate diagnosis of this potentially life-threatening condition at the initial presentation in the Emergency Department after a diving-related injury. An elevated hematocrit in a diver should raise the suspicion for the potential development of capillary leak syndrome requiring specific treatment using albumin infusion as primary fluid replacement.
Copyright © 2013 Elsevier Inc. All rights reserved.
sumber :
J Emerg Med. 2013 Jul;45(1):70-3. doi: 10.1016/j.jemermed.2012.11.101. Epub 2013 Apr 18.
Tayang ulang oleh dr.erick supondha (hyperbaric and diving medicine consultant) dokter ahli hiperbarik dan kesehatan penyelaman , jakarta, indonesia, 021 99070050
