Saturation Diving Decompression Treatment for Severe Type II Decompression Sickness Following Emergency Ascent

Decompression sickness (DCS) is a critical concern in diving operations. Severe type II DCS, characterized by neurological involvement, is particularly disabling and life - threatening. Traditional decompression treatments often show limitations in severe cases. This case report highlights the effectiveness of saturation diving decompression in the treatment of such severe DCS.

A 33-year-old male diver experienced severe type II decompression sickness (DCS) following an emergency ascent from a depth of 56 meters of seawater (msw) due to an underwater explosion. The condition was characterized by coma, as well as bleeding from the nose and ears. Initial treatment utilizing a 60 msw recompression protocol demonstrated limited efficacy, with symptom recurrence observed during the decompression process. Subsequently, a 15 msw air saturation diving decompression treatment was implemented, which extended the stay time at each station to facilitate the desaturation of gas bubbles. The patient's symptoms improved significantly. Repeat MRI 4 days later showed a ≥50 % reduction in lesion volume. The patient was discharged neurologically intact on day 11 and, at 3-month follow-up, had resumed land-based duties without sequelae.

This case underscores the effectiveness of saturation diving decompression in the management of severe DCS, highlighting the critical role of ultra-high-pressure recompression and prolonged desaturation periods.