A case of decompression sickness complicated with multiple organ failure treated by hyperbaric oxygen therapy sequential with continuous renal replacement therapy and extracorporeal membrane oxygenation
10.3760/cma.j.cn121094-20200710-00397
- VernacularTitle:连续肾脏替代疗法和体外膜氧合技术序贯高压氧治疗减压病继发多器官功能衰竭一例
- Author:
Yadong GUAN
1
;
Jianing XU
;
Ji SHEN
;
Yan LU
;
Danfeng CHEN
;
Haining ZHENG
Author Information
1. 210002 南京，东部战区总医院高压氧科
- Keywords:
Diving;
Decompression sickness;
Hyperbaricoxygen therapy;
Multiple organ failure;
Continuous renal replacement therapy;
Extracorporeal membrane oxygenation
- From:
Chinese Journal of Industrial Hygiene and Occupational Diseases
2021;39(5):368-371
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To discuss the new idea of on-the-spot recompression treatment and multidisciplinary treatment (MDT) for patients with unstable vital signs of type II decompression sickness. To provide reference for the nearby treatment of patients with critical decompression sickness.Methods:The clinical data of a case of a multi-disciplinary collaborative treatment of type II decompression sickness complicated with multiple organ dysfunction syndrome (MODS) admitted to a third-class A hospital in January 2020 were analyzed and summarized.Results:The patient suffered from consciousness disturbance and shock after 3 min of diver's blow-up out of the water. CT examination showed gas accumulation in the systemic multi-organ venous system, and laboratory examination suggested MODS. The oxygen inhalation regimen was given in the session of recompression treatmen by 0.12-0.18 MPa. Intravenous fluid was the total of 8900 ml in the session, and the total recompression treatment time was 9 h 45 min. The patient was still in unconscious when he finished the session. CT re-examination confirmed the elimination of venous bubbles, and laboratory examination indicated multiple organ failure (MOF) . The patient was given comprehensive supporting treatment by mechanical assisted breathing and following by continuons renal replacement therapy (CRRT) and extrocorporeal membrane oxygenation (ECMO) in the intensive care unit, and was discharged after 32 d of hospitalization.Conclusion:Critical decompression sickness patients with unstable vital signs are taken to a local general hospital with hyperbaric oxygen chamber and intensive care unit. The successful treatment can be achieved by organizing diving medicine, hyperbaric oxygen medicine and critical medical personnel for MDT.
