The Gradient Perfusion Model Part 3: An extraordinary case of decompression sickness

Undersea Hyperb Med. 2018 May-Jun;45(3):307-311.

Abstract

Introduction: Decompression sickness (DCS) has been associated with unusual circumstances such as breath-hold diving, shallow depths, and short bottom times. We report a case of DCS with an extraordinary cause and course.

Materials and methods: A 72-year-old healthy Hispanic female was referred to our 24/7 Hyperbaric Medicine Unit for emergency hyperbaric oxygen recompression treatment (HBO2 RCT) after developing lower-extremity paralysis following a hyperbaric air exposure in a homemade hyperbaric chamber.

Results: After an uneventful exposure to hyperbaric air at a maximum 72-foot depth (3.2 ATA, 32.3 psig), the patient had the delayed onset of abdominal pain and paraplegia after eating a meal. After HBO2 RCT in accordance with our management algorithm, the patient had a full recovery.

Conclusions: This patient's presentation and course corresponded to what we label as "disordered decompression" and conformed to our Gradient Perfusion Model. With a finite blood volume and the need to perfuse two "intermediate" tissues simultaneously, we postulate that a "steal" syndrome arose to cause the abdominal and paralysis symptoms.

Keywords: decompression sickness; hyperbaric chamber; lower-extremity paralysis.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / diagnostic imaging
  • Abdominal Pain / etiology*
  • Abdominal Pain / therapy
  • Aged
  • Decompression Sickness / etiology*
  • Decompression Sickness / therapy
  • Eating
  • Female
  • Humans
  • Hyperbaric Oxygenation / adverse effects*
  • Hyperbaric Oxygenation / methods
  • Paresis / etiology*
  • Paresis / therapy