Document Detail


Neurologic decompression sickness following cabin pressure fluctuations at high altitude.
MedLine Citation:
PMID:  20377149     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Decompression sickness (DCS) occurs in diving, altitude chamber exposures, and unpressurized or depressurized high-altitude flights. Because DCS takes many forms, in-flight cases may be misinterpreted as hypoxia, hyperventilation, or viral illness, with resulting failure to respond appropriately. In this case, a 28-yr-old male pilot of a single-seat, tactical aircraft experienced 12 rapid pressure fluctuations while flying at 43,000 ft above sea level. He had no symptoms and decided to complete the flight, which required an additional 2 h in the air. Approximately 1 h later he began to experience fatigue, lightheadedness, and confusion, which he interpreted as onset of a viral illness. However, symptoms progressed to visual, cognitive, motor, and sensory degradations and it was with some difficulty that he landed safely at his destination. Neurologic DCS was suspected on initial evaluation by flight line medical personnel because of the delayed onset and symptom progression. He was transferred to a local Emergency Department and noted to have altered mental status, asymmetric motor deficits, and non-dermatomal paresthesias of the upper and lower extremities. Approximately 3.5 h after the incident and 2.5 h after the onset of symptoms he began hyperbaric oxygen therapy. He received partial relief at 30 min of the Navy DiveTable 6 and full resolution at 90 min; there were no recurrent symptoms at a 1-yr follow-up. This case highlights the importance of early recognition of in-flight DCS symptoms and landing as soon as possible rather than as soon as practical in all likely scenarios.
Authors:
Jonathan D Auten; Michael A Kuhne; Harlan M Walker; Henry O Porter
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Aviation, space, and environmental medicine     Volume:  81     ISSN:  0095-6562     ISO Abbreviation:  Aviat Space Environ Med     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-09     Completed Date:  2011-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501714     Medline TA:  Aviat Space Environ Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  427-30     Citation Subset:  IM; S    
Affiliation:
Department of Emergency Medicine, Naval Medical Center San Diego, San Diego, CA 92134, USA. jdauten@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aerospace Medicine
Aircraft*
Altitude*
Altitude Sickness / complications*
Confusion / etiology
Decompression Sickness / etiology*
Dizziness / etiology
Fatigue / etiology
Humans
Male
Military Personnel
Naval Medicine
Nervous System Diseases / etiology*
Risk Factors
Time Factors
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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