PATHOGENETIC FACTORS AND PATHOLOGICAL CONSEQUENCES OF DECOMPRESSION SICKNESS

Abstract

"The evidence is overwhelming that gas bubbles are the primary pathogenetic agent in eliciting the pathologic effects of decompression sickness. Whether they occur after decompression from high pressure atmospheres or to altitude, gas bubbles are chiefly intravascular, and they are held to be responsible for nearly all important phases of the syndrome of decompression sickness. Extravascular gas bubbles occur also under certain severe instances of decompression from high pressure atmospheres, but they are restricted to certain lipid-rich structures. The pathologic effects may be vastly greater after decompression from high pressure atmospheres than to altitude. These are described n detail for the various tissues and organs of the body. An attempt has been made to relate earlier and recent findings to each other, and to the causative factors. Basic to an understanding of the mechanisms involved in the syndrome is a consideration of the physical factors responsible for the uptake and elimination of excess gas in the body. The following physical factors were subjected to analysis: intrinsic factors such as blood pressure, blood flow, tissue permeability, tissue activity, the chemical composition of tissues and the solubility of gases in body components, and extrinsic factors such as the type, rate and extent of decompression applied." The review is limited to those results of decompression which are traceable to aeroembolism.