SEVERE CAPILLARY LEAK SYNDROME AFTER INNER EAR DECOMPRESSION SICKNESS IN A RECREATIONAL SCUBA DIVER
SEVERE CAPILLARY LEAK SYNDROME AFTER INNER EAR DECOMPRESSION SICKNESS IN A RECREATIONAL SCUBA DIVER
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DOI：
10.1016/j.jemermed.2012.11.101
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发表时间：
2013-07-01
影响因子：
1.5
通讯作者：
Louge, Pierre
中科院分区：
文献类型：
--
作者：
Gempp, Emmanuel;Lacroix, Guillaume;Louge, Pierre
背景：在飞行员和专业潜水员的低压和高压暴露的极端条件下，减压后休克伴血浆容量不足是一种非常罕见的事件。病例报告：我们报告了一例严重的低血容量性休克，由于血浆外渗在一个休闲潜水员提出内耳减压病。内皮功能受损可导致毛细血管渗漏，严重时可引起血液浓缩和低血压。该报告提示，减压诱导的循环气泡可能触发了内皮损伤，激活了血管通透性增加的经典炎症途径。结论：这一观察结果强调了在潜水相关损伤后急诊部门首次出现这种可能危及生命的情况时准确诊断的必要性。潜水员的红细胞压积升高应引起对毛细血管渗漏综合征的潜在发展的怀疑，需要使用白蛋白输注作为主要液体替代的特异性治疗。(c) 2013爱思唯尔公司
Background: Post-decompression shock with plasma volume deficit is a very rare event that has been observed under extreme conditions of hypobaric and hyperbaric exposure in aviators and professional divers. Case Report: We report a case of severe hypovolemic shock due to extravasation of plasma in a recreational scuba diver presenting with inner ear decompression sickness. Impaired endothelial function can lead to capillary leak with hemoconcentration and hypotension in severe cases. This report suggests that decompression-induced circulating bubbles may have triggered the endothelial damage, activating the classic inflammatory pathway of increased vascular permeability. Conclusion: This observation highlights the need for an accurate diagnosis of this potentially life-threatening condition at the initial presentation in the Emergency Department after a diving-related injury. An elevated hematocrit in a diver should raise the suspicion for the potential development of capillary leak syndrome requiring specific treatment using albumin infusion as primary fluid replacement. (c) 2013 Elsevier Inc.