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Dysbarism

Last reviewed: 16 Aug 2025
Last updated: 21 Aug 2024

Summary

Definição

História e exame físico

Principais fatores diagnósticos

  • musculoskeletal pain
  • numbness
  • tingling
  • paresthesia
  • nonspecific constitutional symptoms
  • muscular weakness
  • paralysis
  • rash
Detalhes completos

Outros fatores diagnósticos

  • headache
  • ear or sinus pain
  • dizziness or vertigo
  • nausea
  • vomiting
  • shortness of breath
  • tachypnea
  • difficulty in walking
  • reduced hearing
  • middle ear bleeding or tympanic membrane perforation
  • pruritus
  • reduced level of consciousness
  • crackles
  • wheezing
  • reduced breath sounds
  • subcutaneous emphysema
Detalhes completos

Fatores de risco

  • increasing depth and duration of dives (decompression illness)
  • breathing gas mixture
  • rapid ascents (decompression illness)
  • altitude exposure after diving (decompression illness)
  • thermal stress (decompression illness)
  • exercise stress (decompression illness)
  • patent foramen ovale (PFO) (decompression illness)
  • increasing age (decompression illness)
  • high body fat content (decompression illness)
  • dehydration (decompression illness)
  • breath hold diving
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • clinical diagnosis
Detalhes completos

Investigações a serem consideradas

  • chest x-ray
  • ECG
  • echocardiography
Detalhes completos

Algoritmo de tratamento

AGUDA

decompression sickness or arterial gas embolism

barotrauma

nitrogen narcosis

Colaboradores

Autores

Charlotte Sadler, MD

Program Director, Undersea and Hyperbaric Medicine Fellowship

Associate Professor of Clinical Emergency Medicine

University of California, San Diego

La Jolla

CA

利益声明

CS has authored two chapters in UpToDate on diving medicine and fitness to dive, for which she receives royalties. She has also authored chapters on similar topics in CorePendium (online textbook) and Tintinalli's Emergency Medicine - these chapters are not reimbursed. She has previously received grant funding from the PADI Foundation to study COVID-19 in Divers.

Brian Snyder, MD

Clinical Professor of Emergency Medicine

Department of Emergency Medicine

University of California, San Diego

La Jolla

CA

利益声明

BS has updated a number of book chapters as part of his role at the University for which he is not remunerated financially.

Casey Smith, MD

Fellow of Hyperbaric and Dive Medicine

Department of Emergency Medicine

University of California, San Diego

La Jolla

CA

利益声明

A portion of CS's salary as Fellow of Hyperbaric and Dive Medicine was provided by the Diver Alert Network (DAN).

William Toppen, MD

Fellow of Hyperbaric and Dive Medicine

Department of Emergency Medicine

University of California, San Diego

La Jolla

CA

利益声明

A portion of WT’s salary as Fellow of Hyperbaric and Dive Medicine was provided by the Diver Alert Network (DAN).

鸣谢

Dr Charlotte Sadler, Dr Brian Snyder, Dr Casey Smith, and Dr William Toppen would like to gratefully acknowledge Dr Oliver M. Firth and Dr John D. King, both previous contributors to this topic. OMF and JDK declare that they have no competing interests.

同行评议者

Avi Shupak, MD

Head Otoneurology Unit

Carmel and Lin Medical Centers

Haifa

Israel

利益声明

AS declares that he has no competing interests.

John R. Fitz-Clarke, MD, PhD

Staff Hyperbaric Physician

Queen Elizabeth II Health Sciences Centre

Halifax

Nova Scotia

Canada

利益声明

JRFC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Mitchell SJ, Bennett MH, Moon RE. Decompression sickness and arterial gas embolism. N Engl J Med. 2022 Mar 31;386(13):1254-64. 摘要

US Navy. US Navy diving manual revision 7 with change A entered - chapter 17: diagnosis and treatment of decompression sickness and arterial gas embolism. Washington, DC: US Navy; 2018.全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Dysbarism images
  • 鉴别诊断

    • Gas toxicity (decompression illness)
    • Hypercapnia
    • Hyperventilation
    更多 鉴别诊断
  • 指南

    • US Navy diving manual, revision 7 with change A entered. Chapter 17: diagnosis and treatment of decompression sickness and arterial gas embolism
    • Pre-hospital management of decompression illness: expert review of key principles and controversies
    更多 指南
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