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Article: Commentary: The circulatory effects of increased hydrostatic pressure due to immersion and submersion.

Weenink, Robert P / Wingelaar, Thijs T

2022 Volume 13, Page(s) 1029393

Language	English
Publishing date	2022-10-18
Publishing country	Switzerland
Document type	Journal Article ; Comment
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2022.1029393
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Swimming-Induced Pulmonary Edema: New Data Sheds a Light on True Incidence.

Weenink, Robert P / Wingelaar, Thijs T

Chest

2021 Volume 160, Issue 5, Page(s) 1594–1595

MeSH term(s)	Humans ; Incidence ; Military Personnel ; Pulmonary Edema/epidemiology ; Pulmonary Edema/etiology ; Swimming
Language	English
Publishing date	2021-11-07
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1016/j.chest.2021.07.023
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Zs.MO 349: Show issues

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Article: The Circulatory Effects of Increased Hydrostatic Pressure Due to Immersion and Submersion.

Weenink, Robert P / Wingelaar, Thijs T

Frontiers in physiology

2021 Volume 12, Page(s) 699493

Abstract: Increased hydrostatic pressure as experienced during immersion and submersion has effects on the circulation. The main effect is counteracting of gravity by buoyancy, which results in reduced extravasation of fluid. Immersion in a cold liquid leads to ... ...

Abstract	Increased hydrostatic pressure as experienced during immersion and submersion has effects on the circulation. The main effect is counteracting of gravity by buoyancy, which results in reduced extravasation of fluid. Immersion in a cold liquid leads to peripheral vasoconstriction, which centralizes the circulation. Additionally, a pressure difference usually exists between the lungs and the rest of the body, promoting pulmonary edema. However, hydrostatic pressure does not exert an external compressing force that counteracts extravasation, since the increased pressure is transmitted equally throughout all tissues immersed at the same level. Moreover, the vertical gradient of hydrostatic pressure down an immersed body part does not act as a resistance to blood flow. The occurrence of cardiovascular collapse when an immersed person is rescued from the water is not explained by removal of hydrostatic squeeze, but by sudden reinstitution of the effect of gravity in a cold and vasoplegic subject.
Language	English
Publishing date	2021-07-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2021.699493
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Article: Re: Cerebral arterial air emboli on immediate post-endovascular treatment CT are associated with poor short- and long-term clinical outcomes in acute ischaemic stroke patients.

Fakkert, Raoul A / Koopman, Miou S / Preckel, Benedikt / van Hulst, Robert A / Weber, Nina C / Weenink, Robert P

Journal of neuroradiology = Journal de neuroradiologie

2024 Volume 51, Issue 3, Page(s) 256–257

MeSH term(s)	Humans ; Embolism, Air/etiology ; Embolism, Air/diagnostic imaging ; Embolism, Air/therapy ; Ischemic Stroke/diagnostic imaging ; Ischemic Stroke/etiology ; Ischemic Stroke/surgery ; Endovascular Procedures/methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Intracranial Embolism/etiology ; Intracranial Embolism/diagnostic imaging
Language	English
Publishing date	2024-02-19
Publishing country	France
Document type	Letter
ZDB-ID	131763-5
ISSN	1773-0406 ; 0150-9861
ISSN (online)	1773-0406
ISSN	0150-9861
DOI	10.1016/j.neurad.2024.02.005
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Article ; Online: Adjunctive hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries: a systematic review.

Kwee, Esmee / Borgdorff, Marieke / Schepers, Tim / Halm, Jens A / Winters, Hay A H / Weenink, Robert P / Ridderikhof, Milan L / Giannakópoulos, Georgios F

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2024

Abstract: Purpose: Traumatic crush injuries of the lower limb often accompany severe complications. The incorporation of hyperbaric oxygen therapy to standard trauma care may have the potential to diminish injury-related complications and improve outcome in such ... ...

Abstract	Purpose: Traumatic crush injuries of the lower limb often accompany severe complications. The incorporation of hyperbaric oxygen therapy to standard trauma care may have the potential to diminish injury-related complications and improve outcome in such cases. This systematic review aims to evaluate the effectiveness of hyperbaric oxygen therapy in the management of severe lower limb soft tissue injuries. Methods: The electronic databases Medline, Embase and Cochrane Library were searched to identify studies involving patients with crush-associated sever lower limb soft tissue injuries who received hyperbaric oxygen therapy in conjunction with standard trauma care. Relevant data on type of injury, hyperbaric oxygen therapy protocol and outcome related to wound healing were extracted. Results: In total seven studies met the inclusion criteria, involving 229 patients. The studies included two randomized clinical trials, one retrospective cohort study, three case series and one case report. The randomized placebo-controlled clinical trial showed a significant increase in wound healing and decrease in the need for additional surgical interventions in the patient group receiving hyperbaric oxygen therapy when compared to those undergoing sham therapy. The randomized non-placebo-controlled clinical trial revealed that early hyperbaric oxygen therapy reduces tissue necrosis and the likelihood of long-term complications. The retrospective cohort study indicated that hyperbaric oxygen therapy effectively reduces infection rates and the need for additional surgical interventions. The case series and case report presented beneficial results with regard to wound healing when hyperbaric oxygen therapy was added to the treatment regimen. Conclusion: Hyperbaric oxygen therapy is generally considered a safe therapeutic intervention and seems to have a beneficial effect on wound healing in severe lower limb soft tissue injuries when implemented as an addition to standard trauma care.
Language	English
Publishing date	2024-02-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-023-02426-2
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Early hyperbaric oxygen therapy is associated with favorable outcome in patients with iatrogenic cerebral arterial gas embolism: systematic review and individual patient data meta-analysis of observational studies.

Fakkert, Raoul A / Karlas, Noa / Schober, Patrick / Weber, Nina C / Preckel, Benedikt / van Hulst, Robert A / Weenink, Robert P

Critical care (London, England)

2023 Volume 27, Issue 1, Page(s) 282

Abstract: ... to-HBOT and probability of favorable outcome (p = 0.013) that remains significant after correcting ... for severity of manifestations (p = 0.041). Probability of favorable outcome decreases from approximately 65 ...

Abstract	Background: Iatrogenic cerebral arterial gas embolism (CAGE) caused by invasive medical procedures may be treated with hyperbaric oxygen therapy (HBOT). Previous studies suggested that initiation of HBOT within 6-8 h is associated with higher probability of favorable outcome, when compared to time-to-HBOT beyond 8 h. We performed a group level and individual patient level meta-analysis of observational studies, to evaluate the relationship between time-to-HBOT and outcome after iatrogenic CAGE. Methods: We systematically searched for studies reporting on time-to-HBOT and outcome in patients with iatrogenic CAGE. On group level, we meta-analyzed the differences between median time-to-HBOT in patients with favorable versus unfavorable outcome. On individual patient level, we analyzed the relationship between time-to-HBOT and probability of favorable outcome in a generalized linear mixed effects model. Results: Group level meta-analysis (ten studies, 263 patients) shows that patients with favorable outcome were treated with HBOT 2.4 h (95% CI 0.6-9.7) earlier than patients with unfavorable outcome. The generalized linear mixed effects model (eight studies, 126 patients) shows a significant relationship between time-to-HBOT and probability of favorable outcome (p = 0.013) that remains significant after correcting for severity of manifestations (p = 0.041). Probability of favorable outcome decreases from approximately 65% when HBOT is started immediately, to 30% when HBOT is delayed for 15 h. Conclusions: Increased time-to-HBOT is associated with decreased probability of favorable outcome in iatrogenic CAGE. This suggests that early initiation of HBOT in iatrogenic CAGE is of vital importance.
MeSH term(s)	Humans ; Cognition ; Embolism, Air/etiology ; Embolism, Air/therapy ; Hyperbaric Oxygenation/adverse effects ; Iatrogenic Disease ; Linear Models ; Observational Studies as Topic
Language	English
Publishing date	2023-07-12
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2041406-7
ISSN	1466-609X ; 1364-8535
ISSN (online)	1466-609X
ISSN	1364-8535
DOI	10.1186/s13054-023-04563-x
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Zs.A 5517: Show issues

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Article: The Effect of Hyperbaric Oxygen Therapy on Markers of Oxidative Stress and the Immune Response in Healthy Volunteers.

de Wolde, Silke D / Hulskes, Rick H / de Jonge, Stijn W / Hollmann, Markus W / van Hulst, Robert A / Weenink, Robert P / Kox, Matthijs

Frontiers in physiology

2022 Volume 13, Page(s) 826163

Abstract: Hyperbaric oxygen therapy (HBOT) consists of breathing 100% oxygen under increased ambient pressure. There are indications that HBOT induces oxidative stress and activates immune pathways. However, previous research on immunological effects of HBOT has ... ...

Abstract	Hyperbaric oxygen therapy (HBOT) consists of breathing 100% oxygen under increased ambient pressure. There are indications that HBOT induces oxidative stress and activates immune pathways. However, previous research on immunological effects of HBOT has mainly been established in
Language	English
Publishing date	2022-01-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2022.826163
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Article ; Online: Seizures in Iatrogenic Cerebral Arterial Gas Embolism.

Muller, Fenna F / van Hulst, Robert A / Coutinho, Jonathan M / Weenink, Robert P

Critical care explorations

2021 Volume 3, Issue 8, Page(s) e0513

Abstract: Objectives: Iatrogenic cerebral arterial gas embolism occurs when gas enters the cerebral arterial circulation during a medical procedure and is considered a severe complication. Seizures have been described in these patients, but information on ... ...

Abstract	Objectives: Iatrogenic cerebral arterial gas embolism occurs when gas enters the cerebral arterial circulation during a medical procedure and is considered a severe complication. Seizures have been described in these patients, but information on clinical characteristics, treatment, and outcome is lacking in current literature. The aim of the study was to explore seizures in patients with iatrogenic cerebral arterial gas embolism and to evaluate management strategies. Design: Retrospective single-center observational study. Setting: The only university hospital in the Netherlands with a hyperbaric oxygen therapy facility. Patients: All patients presenting at or referred to our center with iatrogenic cerebral arterial gas embolism between May 2016 and December 2020. Interventions: Not applicable. Measurements and main results: Fifteen patients with iatrogenic cerebral arterial gas embolism were identified, of whom 11 (73%) developed seizures. Five patients developed their first seizure prior to hyperbaric oxygen therapy, three during hyperbaric oxygen therapy, and three after hyperbaric oxygen therapy. Of the 11 patients with seizures, all but one were treated with anti-epileptic drugs. With a median follow-up time of 5 months (range, 1-54 mo), five patients showed complete neurologic recovery, five had minor neurologic deficit, two had moderate to severe neurologic deficit, and three had died. Four patients still used anti-epileptic drugs at follow-up. No patients had recurrent seizures after hospital discharge. Conclusions: `Seizures are a common symptom in iatrogenic cerebral arterial gas embolism. They are often treated with anti-epileptic drugs and do not seem to lead to chronic epilepsy.
Language	English
Publishing date	2021-08-13
Publishing country	United States
Document type	Journal Article
ISSN	2639-8028
ISSN (online)	2639-8028
DOI	10.1097/CCE.0000000000000513
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Article ; Online: Computer tomography perfusion patterns in iatrogenic cerebral arterial gas embolism: A retrospective cohort study.

Fakkert, Raoul A / Koopman, Miou S / Scheerder, Maeke J / Beenen, Ludo F M / Weber, Nina C / Preckel, Benedikt / van Hulst, Robert A / Weenink, Robert P

European journal of radiology

2023 Volume 170, Page(s) 111242

Abstract: Purpose: Cerebral arterial gas embolism (CAGE) occurs when air or medical gas enters the systemic circulation during invasive procedures and lodges in the cerebral vasculature. Non-contrast computer tomography (CT) may not always show intracerebral gas. ...

Abstract	Purpose: Cerebral arterial gas embolism (CAGE) occurs when air or medical gas enters the systemic circulation during invasive procedures and lodges in the cerebral vasculature. Non-contrast computer tomography (CT) may not always show intracerebral gas. CT perfusion (CTP) might be a useful adjunct for diagnosing CAGE in these patients. Methods: This is a retrospective single-center cohort study. We included patients who were diagnosed with iatrogenic CAGE and underwent CTP within 24 h after onset of symptoms between January 2016 and October 2022. All imaging studies were evaluated by two independent radiologists. CTP studies were scored semi-quantitatively for perfusion abnormalities (normal, minimal, moderate, severe) in the following parameters: cerebral blood flow, cerebral blood volume, time-to-drain and time-to-maximum. Results: Among 27 patient admitted with iatrogenic CAGE, 15 patients underwent CTP within the designated timeframe and were included for imaging analysis. CTP showed perfusion deficits in all patients except one. The affected areas on CTP scans were in general located bilaterally and frontoparietally. The typical pattern of CTP abnormalities in these areas was hypoperfusion with an increased time-to-drain and time-to-maximum, and a corresponding minimal decrease in cerebral blood flow. Cerebral blood volume was mostly unaffected. Conclusion: CTP may show specific perfusion defects in patients with a clinical diagnosis of CAGE. This suggests that CTP may be supportive in diagnosing CAGE in cases where no intracerebral gas is seen on non-contrast CT.
MeSH term(s)	Humans ; Retrospective Studies ; Tomography, X-Ray Computed/methods ; Embolism, Air/diagnostic imaging ; Cohort Studies ; Perfusion ; Iatrogenic Disease ; Perfusion Imaging/methods ; Cerebrovascular Circulation/physiology ; Stroke ; Brain Ischemia
Language	English
Publishing date	2023-11-30
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	138815-0
ISSN	1872-7727 ; 0720-048X
ISSN (online)	1872-7727
ISSN	0720-048X
DOI	10.1016/j.ejrad.2023.111242
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Article ; Online: Exceptional survival of an airplane stowaway, treated successfully with hyperbaric oxygen.

Schwarte, Lothar A / van der Werf, Huub J / Ridderikhof, Milan L / Fräβdorf, Jan / van Embden, Daphne / Weenink, Robert P

The American journal of emergency medicine

2022 Volume 59, Page(s) 215.e7–215.e9

Abstract: Survival of airplane stowaways is rare. Here we report an exceptional case of successful treatment and full recovery. After a transcontinental flight an unconscious stowaway was discovered in a wheel well of a Boeing 747-400F. Airport paramedics ... ...

Abstract	Survival of airplane stowaways is rare. Here we report an exceptional case of successful treatment and full recovery. After a transcontinental flight an unconscious stowaway was discovered in a wheel well of a Boeing 747-400F. Airport paramedics confirmed regular respiration and achieved 100% oxygen saturation (pulse oximetry) by high-flow oxygen. Rectal body temperature was 35.5 °C. On arrival at the emergency department, the patient's vital signs were stable. He did not respond to verbal stimuli. He localized to painful stimuli with both arms, however, there was no reaction to stimuli to both legs. We suspected his neurological deficits were caused by posthypoxic encephalopathy or altitude decompression sickness (DCS), the latter amenable to hyperbaric oxygen therapy (HBOT). HBOT was performed for 5 h (US Navy Treatment Table 6) and afterwards, full neurological recovery was documented. About 24 h after admission a new proximal paresis of the left leg was noted. Assuming recurrence of DCS, daily HBOT was scheduled for three days, after which motor function had again returned to normal. Stowaways travelling in airplane wheel wells experience extreme environmental circumstances. The presented patient survived an eight-hour exposure to calculated barometric pressures as low as 190 mmHg and ambient PO
MeSH term(s)	Aerospace Medicine ; Aircraft ; Altitude Sickness/complications ; Decompression Sickness/diagnosis ; Decompression Sickness/etiology ; Decompression Sickness/therapy ; Humans ; Hyperbaric Oxygenation ; Male ; Oxygen
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2022-06-12
Publishing country	United States
Document type	Case Reports
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2022.06.021
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