Aviation Decompression Sickness in Aerospace and Hyperbaric Medicine

Area of Science:

• Aerospace Medicine
• Hyperbaric Medicine
• Physiology

Background:

• U.S. Navy aircrew experienced physiological events linked to rapid decompression, with aviation decompression sickness (DCS) suspected.
• Hypobaric DCS pathophysiology mirrors diving-related DCS but is unpredictable due to multifactorial aerospace conditions.
• Aviation DCS diagnosis is complex, situated at the intersection of aerospace and hyperbaric medicine.

Purpose of the Study:

• To review aviation DCS cases diagnosed in a civilian hyperbaric chamber.
• To improve the identification and treatment of hypobaric DCS through collaboration between aerospace and hyperbaric specialists.
• To analyze characteristics differentiating aviation DCS from alternative diagnoses.

Main Methods:

• Retrospective review of 18 cases treated for aviation DCS at a civilian hyperbaric facility.
• Four reviewers with expertise in both aviation and hyperbaric medicine evaluated each case.
• Cases were categorized as either "DCS" or "Alternative Diagnosis".

Main Results:

• Over 50% of the reviewed cases were attributed to an alternative diagnosis.
• DCS was less likely the cause for events below 17,000 ft or with decompression rates under 0.3 atm.
• Specific flight parameters influenced the likelihood of DCS versus other conditions.

Conclusions:

• Aviation physiological events remain difficult to diagnose accurately.
• This study provides insights for flight and hyperbaric physicians to better identify and manage hypobaric DCS.
• Increasing aerospace exploration may lead to a rise in aerospace DCS cases, emphasizing the need for recognition and proper treatment.