[abstract] INVESTIGATION OF DELAYED RECOMPRESSION TREATMENT FOR LIMITING THE INDUCTION OF DYSBARIC OSTEONECROSIS: SHEEP MODEL OF THE DIVER.

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[abstract] INVESTIGATION OF DELAYED RECOMPRESSION TREATMENT FOR LIMITING THE INDUCTION OF DYSBARIC OSTEONECROSIS: SHEEP MODEL OF THE DIVER.

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Title: [abstract] INVESTIGATION OF DELAYED RECOMPRESSION TREATMENT FOR LIMITING THE INDUCTION OF DYSBARIC OSTEONECROSIS: SHEEP MODEL OF THE DIVER.
Author: Lehner, CE; Sobakin, AS; Abraham, JL; Dueland, RT; Wilson, MA; Gendron-Fitzpatrick, AP; Crump, PM; Keuler, NS
Abstract: BACKGROUND: Decompression studies in the UW Diving Physiology Laboratory have investigated the induction of dysbaric osteonecrosis (DON) using the sheep model of the diver and prolonged compressed air exposures and provocative “dropout” decompressions. Dysbaric osteonecrosis may lead to the joint collapse of disabling secondary osteoarthritis. MATERIALS AND METHODS: Twenty-seven adult female sheep (90.5 ± 15.5 SD kg) underwent dry-air chamber exposures at 2.27 atm abs (43 fsw, 12.8 msw) for 24 hours, then rapid or “dropout” decompression at 30 feet/min (0.9 atm/min) to surface followed by air recompression treatment (Modified USN Table 1A) with latencies of 4, 8, 10, or 14 hours. One month after decompression, sheep were injected with 99mTc-methylene diphosphonate (MDP) for bone scans of radii and tibiae to identify “hot spots” signifying long-bone DON lesions. Alizarin complexone fluorochrome was injected IV to visualize DON. Necropsies were used to confirm DON lesions. RESULTS: Of 27 sheep that underwent recompression in the 4 groups, 12 sheep sustained DON lesions with active remodeling. Logistic regression showed that DON occurrence was significantly associated with hours of delayed recompression (Wald p = 0.0146), with the odds of developing DON about twice as large for each additional hour of recompression delay (odds ratio = 1.99; 95% CI [1.15, 3.45]). Based on the logistic model, predicted incidence of DON rose from 4% at 4 hours to 98% at 14 hours, with DON incidence predicted to be 50% at 8.47 hours of delay (95% CI [5.30, 10.52]). CONCLUSIONS: Delaying recompression treatment of limb bends can markedly elevate the incidence of DON and potentially disabling osteoarthritis in the affected diver. (Research was funded by the UW Sea Grant Institute, and the State of Wisconsin. We acknowledge the assistance of Teng-Fu Lin, Manju Kunchur, Ralph Stauffacher, Janet Welter, Rick Nordheim, Bruce Wienke and Glen Moen.)
Description: Abstract of the Undersea and Hyperbaric Medical Society, Inc. Annual Scientific Meeting held June 14-16, 2007. Ritz-Carlton Kapalua Maui, Hawaii (http:www.uhms.org)
URI: http://archive.rubicon-foundation.org/5145
Date: 2007

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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