[The lung overexpansion syndrome as a diving accident. A review of 22 cases]. / El síndrome de sobreexpansión pulmonar como accidente de buceo. Revisión de 22 casos.

Pulmonary barotrauma (PB) is caused by expansion of gases in the respiratory system. We describe 22 cases in divers that constituted 10.2% of the accidents treated at the Spanish navy's hyperbaric center (1969-1990). Hemoptysis (27.2%), subcutaneous emphysema (22.7%) and chest pain (9.1%) were the most frequent thoracic-pulmonary signs. Changes in consciousness (54.5%) and motility (22.7%) were the main neurological symptoms. The highest indices of PB were recorded during training exercises in diving courses, with 91% of the trauma patients recuperating with no aftereffects thanks to prompt deep (50 m) recompression. Protocols for applying therapeutic tables are described, and the advantages of using tables for oxygen as opposed to air are discussed. Finally, we justify the need to have a hyperbaric chamber nearby for treating this type of accident.

[121 cases of decompression disease]. / Estudio de 121 casos de enfermedad descompresiva.

One hundred and twenty-one subjects with decompression disease (DD) treated by the Spanish Navy between 1969 and 1986 are reported. The mean age of the victims was 31.4 +/- 7.2 years. The leading cause of DD was the partial or complete omission of decompression. The development of type I DD (57%) (basically joint pain) was more common than type II (43%) (neurological vestibular and/or pulmonary features). In 84.3% of cases the clinical features began within 6 hours of the end of immersion, although only 61.5% were treated during the initial 6 hours. When therapy was delayed for longer than 6 hours, the rate of sequelae was considerably increased. The rate of complete recovery after treatment in a compression chamber was 92.7% for type I DD and 71.1% for type II DD.