Caisson Disease-Decompression Sickness-Clinical manifestations-Treatment

Caisson Disease (Decompression Sickness)
It is a disease characterized by sudden clinical manifestations that result from a sudden lowering of atmospheric pressure.

Occurs In:
Deep sea and scuba divers, underwater construction workers, and in individuals in unpressurized aircraft that ascend rapidly to
high altitudes.

Pathogenesis:

Deep sea divers or tunnel diggers have gases ( e.g Nitrogen, oxygen and carbon dioxide) dissolved in their blood because they are at under high pressure in these sites. If they ascend too quickly to the surface the dissolved gases become undissolved and form small bubbles within the circulation. Oxygen and carbon dioxide dissolve again but Nitrogen doesn't because it is less soluble in blood. nitrogen bubbles are trapped in the microvasculature and blood flow is blocked and hypoxic injury to the cells takes place.
The same sequence of events occurs when someone ascends from normal pressure to the rarefied atmosphere of high altitudes as in unpressurized aircraft.

Clinical Manifestations.
Following signs and symptoms are found in this disease.

• bends: it refers to sharp pain in joints, limbs and abdomen due to the formation of minute gas bubbles within skeletal muscles and supporting tissues in and around joints.
• Gas emboli may induce foci of necrosis in the brain and other highly vascularized organs.
• Chocks: it refers to sudden respiratory distress due to oedema, haemorrhage and local atelectasis or emphysema in the lungs due to gas emboli

Treatment:

First of all the patient is placed in a compression chamber where barometric pressure can be raised. The rise in pressure will dissolve the nitrogen bubbles. 

then the pressure is slowly decreased over a period of time. this causes a slow release of nitrogen out of the blood into the lungs from where it is
expired out.

Other Topic on emboli;

• Emboli and classification
• Arterial and venous embolus
• Fat embolus
• Gas embolus
• Amniotic Fluid embolus