[abstract] RETURN TO DIVING AFTER BLEOMYCIN THERAPY - CASE REPORT AND REVIEW.

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[abstract] RETURN TO DIVING AFTER BLEOMYCIN THERAPY - CASE REPORT AND REVIEW.

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Title: [abstract] RETURN TO DIVING AFTER BLEOMYCIN THERAPY - CASE REPORT AND REVIEW.
Author: Latson, GW; Hill, JP
Abstract: BACKGROUND: Patients treated with bleomycin may develop pulmonary fibrosis or be sensitized to pulmonary oxygen toxicity. Multiple authors have expressed opinions in the medical literature that patients should not resume diving after bleomycin therapy. A 36 year-old U.S. Navy diver successfully treated for Hodgkin's lymphoma with chemotherapy, including bleomycin, and radiation therapy, desired to resume his career. We critically reviewed the literature, sought expert advice, and formulated a plan to allow his return to diving with careful evaluation. MATERIALS AND METHODS: Review of literature revealed that prevailing opinion against oxygen exposure was based on a small number of case reports with significant confounding variables, casting some doubt on the strength of evidence. We had concerns regarding the risk of oxygen toxicity if he were to require hyperbaric oxygen therapy (HBOT) for decompression sickness, but one recent case series of 11 patients receiving HBOT after bleomycin without problems provided reassuring evidence. Our patient was evaluated with sequential pulmonary function testing (PFT), including spirometry and diffusion capacity for carbon monoxide (DLCO), beginning with baseline tests prior to and 6 months after completion of bleomycin therapy. He was then exposed to graduated levels of hyperbaric air at up to 60 fsw in a dry chamber and in wet dives. His PFT showed no change from baseline after all exposures and he experienced no pulmonary symptoms. RESULTS: The patient was allowed to resume U.S. Navy diving. He subsequently participated in multiple routine and experimental diving operations. During participation in an experimental dive series he experienced DCS, which was successfully treated with HBOT (U.S. Navy Treatment Table 6). PFT after treatment and one week later showed no abnormality. CONCLUSIONS: A patient resumed diving after treatment with bleomycin without pulmonary problems. Under some circumstances, it may be reasonable to allow carefully selected patients to resume diving after bleomycin therapy.
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/5205
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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