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Patent Foramen Ovale Influences the Presentation of Decompression Illness in SCUBA Divers

减压病 卵圆孔未闭 潜水 减压病 医学 回顾性队列研究 介绍(产科) 减压 麻醉 外科 海洋学 偏头痛 地质学
作者
Kevin Liou,Darren Wolfers,Robert S. Turner,Michael H Bennett,Roger Allan,Nigel Jepson,Greg Cranney
出处
期刊:Heart Lung and Circulation [Elsevier]
卷期号:24 (1): 26-31 被引量:24
标识
DOI:10.1016/j.hlc.2014.07.057
摘要

BackgroundFew have examined the influence of patent foramen ovale (PFO) on the phenotype of decompression illness (DCI) in affected divers.MethodologyA retrospective review of our database was performed for 75 SCUBA divers over a 10-year period.ResultsOverall 4,945 bubble studies were performed at our institution during the study period. Divers with DCI were more likely to have positive bubble studies than other indications (p < 0.001).Major DCI was observed significantly more commonly in divers with PFO than those without (18/1,000 v.s. 3/1,000, p = 0.02). Divers affected by DCI were also more likely to require a longer course of hyperbaric oxygen therapy (HBOT) if PFO was present (p = 0.038). If the patient experienced one or more major DCI symptoms, the odds ratio of PFO being present on a transoesophageal echocardiogram was 3.2 (p = 0.02) compared to those who reported no major DCI symptoms.ConclusionPFO is highly prevalent in selected SCUBA divers with DCI, and is associated with a more severe DCI phenotype and longer duration of HBOT. Patients with unexpected DCI with one or more major DCI symptoms should be offered PFO screening if they choose to continue diving, as it may have considerable prognostic and therapeutic implications. Few have examined the influence of patent foramen ovale (PFO) on the phenotype of decompression illness (DCI) in affected divers. A retrospective review of our database was performed for 75 SCUBA divers over a 10-year period. Overall 4,945 bubble studies were performed at our institution during the study period. Divers with DCI were more likely to have positive bubble studies than other indications (p < 0.001). Major DCI was observed significantly more commonly in divers with PFO than those without (18/1,000 v.s. 3/1,000, p = 0.02). Divers affected by DCI were also more likely to require a longer course of hyperbaric oxygen therapy (HBOT) if PFO was present (p = 0.038). If the patient experienced one or more major DCI symptoms, the odds ratio of PFO being present on a transoesophageal echocardiogram was 3.2 (p = 0.02) compared to those who reported no major DCI symptoms. PFO is highly prevalent in selected SCUBA divers with DCI, and is associated with a more severe DCI phenotype and longer duration of HBOT. Patients with unexpected DCI with one or more major DCI symptoms should be offered PFO screening if they choose to continue diving, as it may have considerable prognostic and therapeutic implications.

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