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[Capillary leak syndrome secondary to decompression sickness: A case report]
J Morin1, K Simon2, F Chadelaud3
1Service de médecine hyperbare et expertise plongée (SMHEP), hôpital d'instruction des armées (HIA) Sainte-Anne, BP 600, 83800 Toulon cedex 9, France.
Background:
Capillary leak syndrome is a rare type of decompression sickness (DCS) that may be responsible for hypovolemic shock with edema.
Clinical Case:
A 21-year-old amateur diver suffered from an inner ear DCS following air diving to 96msw. He presented subsequent deterioration with hypovolemia and facial edema secondary to capillary leak syndrome.
Discussion:
In DCS, bubbles formation alters the wall of blood vessels and activates complex biochemical mechanisms inducing extravascular protein leakage. The clinical expression of this syndrome is variable, ranging from simple hemoconcentration to hypovolemic shock. Close clinical-biological monitoring of patients with elevated hematocrit with or without hypoalbuminemia is advisable. Early vascular filling with albumin infusion may prevent the occurrence of hypovolemic shock and improve the prognosis.
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