The Pathophysiology of Decompression Sickness: An Overview with Emphasis on Plasma and Lipid Changes.

Abstract : Several significant findings or trends have been noted over the past 12 years. Lipid emboli coexist with gaseous emboli in moderately severe decompression sickness. Lipid emboli can be altered following early intravenous therapy. Dextran (LMW or MMW) is effective as an antilipemic clearing agent. An excellent colloidal expander, dextran should be used in the treatment of severe decompression sickness, particularly if a recompression chamber is miles away. Human divers may manifest changes in hematocrit, platelet and selected coagulation factors. These trends are of interest and can perhaps herald the onset of decompression sickness if the plasma changes are significantly altered beyond the levels shown by volunteer divers. The lungs serve as a primary target organ for trapping emboli. Disruption of alveoli at this site may lead to air embolism. Careful monitoring of the brain and eyeground can be of assistance in following the more severely afflicted patient.