SEARCH · PubMed Health

Results for “Decompression”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources

PubMedDate not supplied

A pilot study comparing percutaneous decompression with decompressive laparotomy for acute abdominal compartment syndrome in thermal injury.

Abdominal Compartment Syndrome (ACS) has multiple causes, and decompressive laparotomy has been the most frequent modality to prevent worsening cardiovascular, respiratory, and renal function. This pilot study evaluated the utility of percutaneous drainage (PD) of peritoneal fluid compared with decompressive laparotomy in burn patients. A 26-month review was conducted. Nine of 13 (69%) study patients developed intra-abdominal hypertension (IAH) that progressed to abdominal compartment syndrome in 4 (31%). All were treated with PD using a diagnostic peritoneal lavage catheter. Peritoneal fluid analysis revealed a sterile plasma ultrafiltrate with electrolyte and other chemistries reflecting patient serum levels. Five patients underwent PD successfully, and their IAH did not progress to ACS. Four patients with greater than 80% TBSA and severe inhalation injury did not respond to PD and required decompressive laparotomy. There was no evidence of bowel edema, ischemia, or necrosis. All patients requiring decompressive laparotomies died either from sepsis or respiratory failure. Percutaneous decompression is a safe and effective method of decreasing IAH and preventing ACS in patients with less than 80% TBSA thermal injury.

Abdomen↗

PubMed1988

Decompression sickness and the role of exercise during decompression.

The risk of decompression sickness (DCS) is greatly increased with exercise at altitude. Bends is the commonest symptom in altitude DCS. Though the adverse effect of exercise at altitude is well known, the role of exercise during decompression is not clear. In this paper, a case of bends occurring with exercise during accidental decompression is presented. The event occurred while exercising on a treadmill at an altitude of approximately 4,572 m (15,000 ft) in the hypobaric chamber. No oxygen pre-breathe was done and ambient air was breathed throughout. The role of hypoxia and exercise during decompression, as well as individual susceptibility, are discussed. Even moderately severe exercise at low altitude may predispose healthy individuals breathing ambient air to DCS, especially when exercise is undertaken during decompression.

Adult↗

PubMed1997

Active compression-decompression cardiopulmonary resuscitation (ACD-CPR) compared with standard CPR in a manikin model--decompression force, compression rate, depth and duration.

During active compression-decompression cardiopulmonary resuscitation (ACD-CPR), the rescuer applies traction to the chest between compressions. Under experimental conditions, cardiac output increases, possibly through accentuated intrathoracal pressure fluctuations. ACD-CPR requires specific training and may be more complex to perform than standard CPR. The aim of this study was to characterize ACD-CPR performance compared with standard CPR by emergency care providers; in terms of decompression force, compression rate, depth and duration. Thirty-three ambulance paramedics were studied while performing standard CPR and ACD-CPR with the Ambu Cardiopump on a specially designed transducer-equipped manikin 9 months following initial training. The order of CPR performance was determined randomly by cross-over design. Performance data were recorded by a computer. The 2-min average active decompression force was 9.3 kg (interquartile range 2.5-15.3 kg) and six subjects (18%) met the manufacturers recommendation of 10-15 kg. External chest compression (ECC) rate decreased from 85 (70-101) to 76 (63-88) min-1 (P < 0.001), ECC depth decreased from 54 (50-58) to 45 (39-48) mm (P < 0.001) and compression duration from 40 (35-45) to 31% (28-33%) (P < 0.001) upon change from standard CPR to ACD-CPR. We conclude that the recommended level of decompression force was achieved by less than one fifth of study subjects. ACD-CPR when compared with standard CPR causes a consistent and significant reduction of compression rate, depth and duration. These are all factors of possible clinical significance. Training in ACD-CPR should address this issue, with special emphasis on optimal decompression force and ECC rate.

Adult↗

PubMed1996

Colon decompression using an anatomically adapted, large-caliber decompression probe.

Intestinal pseudo-obstruction, paralytic (e.g. postoperative or drug-induced) hyperdistension of the large bowel and colonic stenosis often require endoscopic decompression. The decompression probes currently available have the disadvantage of an insufficiently large diameter or inadequate adaptation to the given anatomic configuration of colon, or both. A new decompression probe system consisting of a guide wire, a 12-Fr polyethylene guide catheter, and a 24-Fr polyurethane decompression probe, is presented and two cases are described. The probe was tested in a pilot study in 16 patients. In all patients, implantation was successfully performed without complications. No undesired dislocation was observed. The introduction time varied between four and 16 minutes. Clinically successful decompression was achieved in 14 of the 16 patients.

Aged↗

PubMed2000

Balanced orbital decompression in Graves' orbitopathy: Upper eyelid crease incision for extended lateral wall decompression.

INTRODUCTION. This study reports on the results and complications detected in patients with Graves' orbitopathy who underwent balanced medial and lateral wall orbital decompression through concealed incisions. MATERIALS AND METHODS. The medial and lateral orbital walls of nine consecutive patients (14 eyes) were removed. A transnasal endoscopic spheno-ethmoidectomy was performed for the medial wall decompression. A lateral wall decompression was performed via an upper eyelid crease incision which was extended laterally in a relaxed skin tension line. The lateral aspect of the orbit was sculpted with a high-speed surgical drill from the inferior orbital fissure inferiorly and frontal bone of the lacrimal fossa superiorly to the orbital apex posteriorly, including the thick bone of the greater wing of the sphenoid. RESULTS. The decompression was performed for cosmetic purposes in seven patients (10 orbits) and for exposure keratopathy and restrictive myopathy in the remaining two patients (4 orbits). The average follow-up period was 13.6 months. The mean reduction of proptosis was 4.8 mm. The preoperative diplopia in two cases demonstrating restrictive myopathy worsened during the postoperative period. New onset diplopia was not detected in seven cases operated on for cosmetic purposes. All patients were satisfied with their eye status, visual rehabilitation and cosmetic appearance. CONCLUSIONS. The transnasal endoscopic approach for medial wall and extended lateral wall decompression with hidden eyelid crease incision provides a favorable cosmetic and physiologic outcome with proper retroplacement of the globe.

Journal Article↗

PubMed1996

[Agee endoscopic decompression of the median nerve: prospective study with comparison to open decompression].

This prospective randomized study consists of 45 patients, i.e., 33 women and 12 men with an average age of 52.7 years. The following parameters were evaluated: rate of complications, recovery of pinch and strength of grip, radiological widening of the transverse carpal arch, postoperative morbidity, particularly the time of return to work, and to activities of daily living. Compared with open decompression, the group of endoscopic decompression needs significantly less time to get back to work (one third; p = 0.003). This seems to be related to a significantly faster restoration of strength of grip (p = 0.f12) after endoscopic decompression of the median nerve. Pinch grip improves faster in the group of endoscopic decompression as well, however, not significantly, compared with open decompression. No significant difference between the two techniques has been detected in the radiological widening of the transverse carpal arch.

Adult↗

PubMed2001

On the likelihood of decompression sickness during H(2) biochemical decompression in pigs.

A probabilistic model was used to predict decompression sickness (DCS) outcome in pigs during exposures to hyperbaric H(2) to quantify the effects of H(2) biochemical decompression, a process in which metabolism of H(2) by intestinal microbes facilitates decompression. The data set included 109 exposures to 22-26 atm, ca. 88% H(2), 9% He, 2% O(2), 1% N(2), for 0.5-24 h. Single exponential kinetics described the tissue partial pressures (Ptis) of H(2) and He at time t: Ptis = integral (Pamb - Ptis). tau(-1) dt, where Pamb is ambient pressure and tau is a time constant. The probability of DCS [P(DCS)] was predicted from the risk function: P(DCS) = 1 - e(-r), where r = integral (Ptis(H(2)) + Ptis(He) - Thr - Pamb). Pamb(-1) dt, and Thr is a threshold parameter. Inclusion of a parameter (A) to estimate the effect of H(2) metabolism on P(DCS): Ptis(H(2)) = integral (Pamb - A - Ptis(H(2))). tau(-1) dt, significantly improved the prediction of P(DCS). Thus lower P(DCS) was predicted by microbial H(2) metabolism during H(2) biochemical decompression.

Animals↗

PubMed2002

Modulation of decompression sickness risk in pigs with caffeine during H(2) biochemical decompression.

In H(2) biochemical decompression, H(2)-metabolizing intestinal microbes remove gas stored in tissues of animals breathing hyperbaric H(2), thereby reducing decompression sickness (DCS) risk. We hypothesized that increasing intestinal perfusion in pigs would increase the activity of intestinal Methanobrevibacter smithii, lowering DCS incidence further. Pigs (Sus scrofa, 17-23 kg, n = 20) that ingested caffeine (5 mg/kg) increased O(2) consumption rate in 1 atm air by ~20% for at least 3 h. Pigs were given caffeine alone or caffeine plus injections of M. smithii. Animals were compressed to 24 atm (20.5-23.1 atm H(2), 0.3-0.5 atm O(2)) for 3 h, then decompressed and observed for signs of DCS. In previous studies, DCS incidence in animals without caffeine treatment was significantly (P < 0.05) lower with M. smithii injections (7/16) than in controls (9/10). However, contrary to our hypothesis, DCS incidence was marginally higher (P = 0.057) in animals that received caffeine and M. smithii (9/10) than in animals that received caffeine but no M. smithii (4/10). More information on gas kinetics is needed before extending H(2) biochemical decompression to humans.

Animals↗

PubMed1999

Degenerative lumbar spinal stenosis. Long-term results after undercutting decompression compared with decompressive laminectomy alone or with instrumented fusion.

The aim of the study was to evaluate the long-term outcome of various surgical procedures for lumbar spinal stenosis. Operations were performed on 117 consecutive patients for lumbar spinal stenosis between 1987 and 1992. Pre- and intraoperative data were recorded in a standardized manner. Three treatment groups were distinguished: group I consisting of 39 patients submitted to undercutting decompression; group II, 51 patients, submitted to laminectomy and foraminal decompression alone; and group III, 27 patients, who underwent foraminal decompression and laminectomy with instrumented fusion. Eight years (5-10 years) after surgery a questionnaire was mailed to the patients containing the outcome scales according to Greenough and Fraser [6] and Turner et al. [22] together with questions about residual pain, necessity of treatment and satisfaction with the operative outcome. A total of 72 questionnaires (61.6%) gave enough information for analysis. After a mean follow-up of 8 years, walking capacity had increased significantly in all groups (P < 0.001). Compared to preoperative values, pain had decreased significantly in all groups (P < 0.01). In group I 36% had good-to-excellent outcomes, and 30.8% and 23.8% in groups II and III (P > 0.05). Forty percent of group I patients were unsatisfied with the result, compared to 38.4% and 33.3% in the other groups (P > 0.05). Overall, 25 of 72 patients (34.7%) had severe constant back and/or leg pain requiring daily administration of analgesics. We conclude that the long-term outcome of decompressive surgery of the lumbar spinal canal, without and with instrumented fusion, is less favourable than was previously reported.

Aged↗

PubMed2003

Probabilistic modelling for estimating gas kinetics and decompression sickness risk in pigs during H2 biochemical decompression.

We modelled the kinetics of H2 flux during gas uptake and elimination in conscious pigs exposed to hyperbaric H2. The model used a physiological description of gas flux fitted to the observed decompression sickness (DCS) incidence in two groups of pigs: untreated controls, and animals that had received intestinal injections of H2-metabolizing microbes that biochemically eliminated some of the H2 stored in the pigs' tissues. To analyse H2 flux during gas uptake, animals were compressed in a dry chamber to 24 atm (ca 88% H2, 9% He, 2% O2, 1% N2) for 30-1440 min and decompressed at 0.9 atm min(-1) (n = 70). To analyse H2 flux during gas elimination, animals were compressed to 24 atm for 3 h and decompressed at 0.45-1.8 atm min(-1) (n = 58). Animals were closely monitored for 1 h post-decompression for signs of DCS. Probabilistic modelling was used to estimate that the exponential time constant during H2 uptake (tau(in)) and H2 elimination (tau(out)) were 79 +/- 25 min and 0.76 +/- 0.14 min, respectively. Thus, the gas kinetics affecting DCS risk appeared to be substantially faster for elimination than uptake, which is contrary to customary assumptions of gas uptake and elimination kinetic symmetry. We discuss the possible reasons for this asymmetry, and why absolute values of H2 kinetics cannot be obtained with this approach.

Animals↗

PubMed2005

Endoscopic vascular decompression versus microvascular decompression of the trigeminal nerve.

Microvascular decompression (MVD) is a highly accepted and effective method for treatment of patients with trigeminal neuralgia in whom compression of the nerve by a vascular structure is implicated in the pathogenesis of the disease. However, recent reports have highlighted the advantages of the endoscope in visualizing structures within the cerebellopontine angle. Additional research, using the endoscope to supplement the microscopic procedure, has demonstrated improved localization of neurovascular conflicts. In this report we present the results of our series utilizing a fully endoscopic vascular decompression (EVD) technique, and compare these results to those published for microvascular decompression. From September 1999 until October 2004, 255 patients underwent endoscopic vascular decompression of the trigeminal nerve. These patients' records were retrospectively reviewed, and additional data from follow-up visits were collected and analyzed to ascertain success rates and review the incidence of complications. From a total of 255 patients who underwent EVD of the trigeminal nerve we noted an initial, complete, postoperative success rate in 95 % of patients. Initial, being defined as within the first 3 months postoperative, and "complete" being judged if the patient reported 98 % relief of pain postoperatively without the need for medication (Barker's classification). Additionally, we documented a 93 % complete success rate for 118 patients who completed at least a three-year follow-up period. Complication rates were compared to those reported for MVD. There were no serious complications or mortality in this series. We conclude that EVD is a safe and effective method to remove neurovascular conflicts related to the trigeminal nerve. The results of this series demonstrate an improved rate of trigeminal neuralgia relief with EVD when compared to MVD, a lower incidence of complications and a better outcome.

Adult↗

PubMed2005

Anterior decompression combined with corpectomies and discectomies in the management of multilevel cervical myelopathy: a hybrid decompression and fixation technique.

OBJECT: The authors retrospectively evaluated the safety and efficacy of a decompression and fixation technique in the treatment of patients with multilevel cervical spondylotic myelopathy (CSM). METHODS: The authors describe the "hybrid decompression fixation" technique, a procedure involving a combination of corpectomies and discectomies to preserve a vertebra intact within the area of the decompression, thus augmenting mechanical stability. The authors retrospectively reviewed outcomes in 25 patients with multilevel CSM in whom the hybrid technique was performed between 1999 and 2003. Twelve patients underwent a single-level corpectomy and three-level discectomies. In 13 patients a two-level corpectomy and adjacent four-level discectomies were conducted, leaving a vertebral bridge the middle. All patients underwent fusion involving placement of disc and vertebral body cages filled with autogenous local bone and supplemental anterior dynamic plate fixation. The mean preoperative Nurick grade was 3 and improvement in status was reflected by a postoperative decrease to 2.6 (p < 0.05). In one patient neurological deterioration was demonstrated. At the end of the follow-up period (mean 29 months) radiography revealed evidence of osseous fusion in 24 patients; fusion status could not be determined in one patient. No evidence of late-onset instrumentation-related failure was observed in any of the 25 patients. CONCLUSIONS: The authors found the hybrid technique to be safe and efficient for anterior decompression in patients with multilevel CSM. The use of this technique obviates the need for staged circumferential procedures.

Aged↗

PubMed2005

Percutaneous needle decompression during laparoscopic gastric surgery: a simple alternative to nasogastric decompression.

Laparoscopic gastric surgeries are routinely performed with use of a nasogastric tube to decompress the upper gastrointestinal tract. A distended upper gastrointestinal tract can complicate successful laparoscopic gastric surgery as the distention compromises not only the visual field but also the laparoscopic manipulation of the stomach. Since nasogastric intubation is not without risks, we have attempted laparoscopic-assisted gastric cancer surgeries without nasogastric tubes. In this article we describe a simple method of aspirating gastric contents using a 9 cm long 19-gauge needle inserted percutaneously during laparoscopic-assisted gastrectomy. First, a 9 cm long 19-gauge disposable needle was introduced through the abdominal wall. This needle was then introduced to the stomach through the anterior wall and the stomach gases and fluids were aspirated by connecting the needle to suction. Thus, a collapsed upper gastrointestinal tract was easily obtained. We performed this procedure instead of nasogastric decompression on twenty-two patients with gastric cancer who underwent laparoscopic-assisted distal subtotal gastrectomy with lymph node dissection. The results were good with only one patient experiencing wound infection (4.5%) and one patient with postoperative acalculus cholecystitis (4.5%). There were no patients with either intraabdominal infection or anastomotic leakage and none of the patients needed postoperative nasogastric decompression, except the patient who experienced acaculus cholecystitis. Percutaneous needle aspiration is a very simple and efficient technique with little risk of postoperative complications. It can be used as an alternative to nasogastric tube decompression of the gastrointestinal tract for laparoscopic-assisted gastrectomy.

Adult↗

PubMed2000

Delayed onset pulmonary barotrauma or decompression sickness? A case report of decompression-related disorder.

A-24-yr-old male professional diver began to complain of substernal pain 3 h after a controlled ascent from a dive of less than 40 ft of sea water (fsw). The diving master who supervised his dive and the physicians who examined him on presentation suspected pulmonary barotrauma rather than decompression sickness (DCS) because he had only descended to a depth of 32 fsw. Hyperbaric oxygen therapy (HBO) by U.S. Navy treatment Table VI was implemented because of his progressively worsening pain. HBO was apparently effective and a relapse was not seen. The author cannot label his condition based on the conventional classification categories, such as decompression sickness (DCS), barotrauma or even decompression illness. This case report is offered as a topic for consideration in the controversy over decompression-related disorders.

Adult↗

PubMed2001

Effect of ambient temperature on the risk of decompression sickness in surface decompression divers.

BACKGROUND: Several studies have noted an apparent increase in decompression sickness (DCS) risk with surface decompression diving in warm water or with hot water suits (Van Der Aue 1951, Shields 1986, Leffler 1997), but did not perform statistical tests to control for the pressure-time profile. METHODS: The 1986 data, including 73 DCS cases out of 14,891 dives, were analyzed by Mantel-Haenszel analysis to control for depth and bottom time. Dive profiles from the 1951 U.S. Navy report, including 147 DCS cases from 1507 dives, were analyzed with logistic regression analysis to control for depth, bottom time, and aspects of the decompression profile. RESULTS: In the 1986 data, hot water suits, as compared with passive thermal protection, were associated with an odds ratio (OR) of 1.81 (95% confidence interval, CI = 0.96 to 3.42) for DCS. In the 1951 data, each 10 degree C increase in water temperature yielded an OR for DCS of 1.96 (95% CI = 1.33 to 2.90). The interaction of temperature and bottom time suggested that the effect was more pronounced in shorter dives. Among DCS cases, the OR for type 2 symptoms with hot water suits was not significant in the 1986 data (p = 0.18). In the 1951 data, the probability of type 2 symptoms among DCS cases was better explained by the dive profile than by the temperature. Thermal effects on gas physics, metabolism, hemostasis, and nociception were reviewed. CONCLUSION: Surface decompression divers who are warm at depth face an increased risk of DCS. Vasodilatation in warm divers may result in more rapid on-gassing of tissues with short time constants. A full evaluation of DCS risk should consider physiological and physical effects of ambient temperature.

Decompression Sickness↗

PubMed1989

Sensory recovery in the plantar aspect of the foot after surgical decompression of posterior tibial nerve. Possible role of steroids along with decompression.

In leprosy, involvement of the posterior tibial nerve leads to sensory loss in the plantar aspect of the foot. As a result plantar ulcers are common and lead to deformity and disability. Restoration of plantar sensation can prevent ulcer formation. Posterior tibial decompression was done for the recovery of sensation in the plantar aspect of the foot. Seventy-two patients under went decompression on 84 feet, 25 received steroids pre- and post-operatively. The recovery of sensation was better if surgery was done before 6 months of onset of anaesthesia. Decompression along with steroids gave better results than decompression alone in patients with active neuritis especially in BT cases whereas in BB, BL and LL cases there was no significant improvement of sensation. The results are discussed.

Adolescent↗

PubMed1995

Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. The Ischemic Optic Neuropathy Decompression Trial Research Group.

OBJECTIVE: To assess the safety and efficacy of optic nerve decompression surgery compared with careful follow-up alone in patients with nonarteritic anterior ischemic optic neuropathy (NAION). DESIGN: The Ischemic Optic Neuropathy Decompression Trial (IONDT) is a randomized, single-masked, multicenter trial. SETTING: Twenty-five US clinical centers. PARTICIPANTS: The IONDT ceased recruitment on October 20, 1994, on the recommendation of its Data and Safety Monitoring Committee. The preliminary results presented herein are based on data as of September 8, 1994, from 244 patients with NAION and visual acuity of 20/64 or worse. One hundred twenty-five patients had been randomized to careful follow-up, and 119 had been randomized to surgery, with 91 and 95, respectively, having completed 6 months of follow-up. INTERVENTION: Patients in the surgery group received optic nerve decompression surgery and follow-up ophthalmologic examinations; those in the careful follow-up group received ophthalmologic examinations at the same times as the surgery group. MAIN OUTCOME MEASURES: Gain or loss of three or more lines of visual acuity on the New York Lighthouse chart at 6 months after randomization, as measured by a technician masked to treatment assignment. RESULTS: Patients assigned to surgery did no better when compared with patients assigned to careful follow-up regarding improved visual acuity of three or more lines at 6 months: 32.6% of the surgery group improved compared with 42.7% of the careful follow-up group. The odds ratio (OR) for three or more lines better, adjusted for baseline visual acuity and diabetes, was 0.74 (95% confidence interval [CI], 0.39 to 1.38). Patients receiving surgery had a significantly greater risk of losing three or more lines of vision at 6 months: 23.9% in the surgery group worsened compared with 12.4% in the careful follow-up group. The 6-month adjusted OR for three or more lines worse was 1.96 (95% CI, 0.87 to 4.41). No difference in treatment effect was observed between patients with progressive NAION and all others. CONCLUSION: Results from the IONDT indicate that optic nerve decompression surgery for NAION is not effective, may be harmful, and should be abandoned. The spontaneous improvement rate is better than previously reported.

Aged↗

PubMed2004

Early external decompressive craniectomy with duroplasty improves functional recovery in patients with massive hemispheric embolic infarction: timing and indication of decompressive surgery for malignant cerebral infarction.

BACKGROUND: Extensive cerebral hemispheric infarction associated with massive brain swelling is known as malignant infarction because of the rapid clinical deterioration and mortality as high as 80% unless appropriate treatment is performed. Decompressive craniectomy is an effective treatment, but patient selection, timing, functional recovery, and complications remain unclear. METHODS: Seventy-one patients with massive embolic hemispheric infarctions (infarct volume >200 cm(3)) associated with brain swelling were retrospectively divided into 3 groups according to the therapeutic modalities: 21 patients were treated conservatively (conservative group); 50 patients were treated by external decompressive craniectomy with duroplasty in 2 groups; 29 patients treated after the appearance of clinical and radiologic findings of brain herniation (late surgery group); and 21 patients treated before the onset of brain herniation (early surgery group). RESULTS: The mortality at 1 and 6 months in the conservative group were 61.9% and 71.4%, respectively. The mortality at 1 and 6 months in the late surgery group were significantly improved to 17.2% and 27.6%, respectively, (p < 0.01) and in the early surgery group were further improved to 4.8% and 19.1%, respectively. The functional recovery of the patients was estimated by the Glasgow Outcome Scale (GOS) and Barthel Index (BI) at 6 months after the ictus. The GOS scores of the early surgery group were significantly better than that of the late surgery group (p < 0.05). The mean BI score of the survivors in the late surgery group (26.9 +/- 30.4) was not significantly different from that of the conservative group (28.3 +/- 42.2), but was significantly improved in the early surgery group (52.9 +/- 34.2) compared with the late surgery group (p < 0.05). CONCLUSIONS: Early decompressive craniectomy with duroplasty before the onset of brain herniation should be performed to achieve satisfactory functional recovery if the infarct volume of the hemispheric cerebral infarction is more than 200 cm(3) and computed tomography on the second day after the ictus shows mass effect.

Adult↗