Information about venous gas emboli improves prediction of hypobaric decompression sickness. 1998

J Conkin, and M R Powell, and P P Foster, and J M Waligora
Universities Space Research Association, Division of Space Life Sciences, Houston, TX, USA.

OBJECTIVE Information about venous gas emboli (VGE) detected in the pulmonary artery such as the occurrence of VGE, Grade of VGE, the time when VGE first appear, and the time course of the Grade or occurrence of VGE, could be used to better assess the probability of decompression sickness [P(DCS)] in any hypobaric decompression. We hypothesized that these data would improve the estimate of P(DCS) since objective measurements of the decompression stress are available for the individual. METHODS A binary correlation and survival analysis approach were used on information from 1,322 hypobaric chamber exposures to establish the relationships between VGE and DCS. RESULTS Based on the correlation analysis, the absence of VGE is highly correlated with the absence of a DCS symptom, as evident from a negative predictive value of 0.98. However, the presence of VGE in the pulmonary artery is not highly correlated with a subsequent DCS symptom, as evident from a positive predictive value of 0.39 for Grades III and IV VGE. The correlation results suggest the presence of VGE in the pulmonary artery is a necessary, but not sufficient, condition for DCS. Based on the survival analysis, the log logistic survival model, a one-variable model with two parameters gave a log likelihood (LL) of -757. This model was expanded to include seven additional variables, including four about VGE, and the nine-parameter model gave a better LL of -481. CONCLUSIONS Information about VGE plus other variables known to influence DCS is useful to better assess the P(DCS) for hypobaric decompressions.

UI MeSH Term Description Entries
D008297 Male Males
D008889 Military Personnel Persons including soldiers involved with the armed forces. Air Force Personnel,Armed Forces Personnel,Army Personnel,Coast Guard,Marines,Navy Personnel,Sailors,Soldiers,Submariners,Military,Force Personnel, Air,Personnel, Air Force,Personnel, Armed Forces,Personnel, Army,Personnel, Military,Personnel, Navy,Sailor,Soldier,Submariner
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011651 Pulmonary Artery The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. Arteries, Pulmonary,Artery, Pulmonary,Pulmonary Arteries
D003665 Decompression Sickness A condition occurring as a result of exposure to a rapid fall in ambient pressure. Gases, nitrogen in particular, come out of solution and form bubbles in body fluid and blood. These gas bubbles accumulate in joint spaces and the peripheral circulation impairing tissue oxygenation causing disorientation, severe pain, and potentially death. Bends,Caisson Disease,Caisson Diseases,Disease, Caisson,Diseases, Caisson,Sickness, Decompression
D004618 Embolism, Air Blocking of a blood vessel by air bubbles that enter the circulatory system, usually after TRAUMA; surgical procedures, or changes in atmospheric pressure. Air Embolism,Embolism, Gas,Air Embolisms,Embolisms, Air,Embolisms, Gas,Gas Embolism,Gas Embolisms
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000337 Aerospace Medicine That branch of medicine dealing with the studies and effects of flight through the atmosphere or in space upon the human body and with the prevention or cure of physiological or psychological malfunctions arising from these effects. (from NASA Thesaurus) Aviation Medicine,Space Medicine,Medicine, Aerospace,Medicine, Aviation,Medicine, Space

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