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Revista Medica Herediana

Print version ISSN 1018-130XOn-line version ISSN 1729-214X

Abstract

ABARCA TORRES, Isaac Pedro; CASTRO ALFARO, Oswaldo  and  GUERRA BUENDIA, Felipe. Escape libre de submarino hundido: tratamiento hiperbárico de las enfermedades de buceo. Rev Med Hered [online]. 2000, vol.11, n.3, pp.71-78. ISSN 1018-130X.

In August of 1988 the sinking of the submarine Pacocha of the Peruvian Army took place, where 22 tripulantes was caught should carry out free escape. Objective: To determine the treatment and immediate evolution of the Decompression Sickness (DS) after the accident. Material and Methods: The accident technical and medical records were revised retrospectively and the clinical histories of the Salvage Service of the Marine too. The Workman and Goodman treatment charts were used. Results: The 22 survivors were subjected between 16 and 23 hours to a calculated pressure of 90 feet of sea water. After the escape the 22 suffered DS: 7 DS type I (DS I) (31.8%) and 15 DS II (68.2%). There were no diagnosed cases of Arterial Gas Embolism (AGE). All received therapy in hyperbaric camera, eight had a delay more than 24 hours, The treatment charts used were: the chart 6 for 3 cases of DS II and 5 of DS I and the chart 6A for 8 cases of DS II. The treatment of three patients was made abbreviating the established charts initially, two of them presented post treatment recurrence and 2 worsened after its first therapy session being with neurological sequel. In general six cases presented post treatment recurrence (27.27%); three had unfavorable clinical result after the first session (13.64%) and two had neurological sequel (9.09%). There was not statistical relationship among the delay in the treatment and the presence of post treatment recurrences neither with the unfavorable result. The mortality was of 4.54% (1 case of DS II treaty with chart 6A). Only 2 of the patients treaties after 24 hours had post treatment recurrences, evolving all favorably. Conclusions: The recompressive treatment should be immediate, independently of the severity of the clinical manifestations of beginning. Of not being possible the retarded treatment more than 24 hours is even effective. The established treatment charts, are effective for the treatment of the decompression accident, but they should be employees ad integrum according to the diagnosis to avoid sequels, recurrence and worsening. ( Rev Med Hered 2000; 11:71-78 ).

Keywords : Decompression sickness; hyperbaric treatment.

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