The role of ECMO in the management of pulmonary barotrauma in people with decompression sickness: Literature review

Aim: This literature review investigates the role of ECMO in the management of pulmonary barotrauma in people with decompression sickness (DCS). Background: As a result of change in the atmospheric pressure in sea depth, divers may experience life threatening conditions such as barotrauma in vital organs including the lungs. Delivering 100% oxygen is the immediate treatment in these situations. A modern technology for oxygen therapy and supporting vital organs in heart and lung failure is extracorporeal membrane oxygenation (ECMO). Method: This review was conducted by searching out databases UpToDate, Google scholar, Elsevier, SID and Magiran between 1995-2016 by the following keywords: diver, diving, decompression sickness, decompression syndrome, lung injuries, respiratory disorders, pulmonary barotrauma, treatment, and ECMO, and their Persian equivalents. Findings: Oxygen administration and prevention of severe complications caused by accumulation of nitrogen bubbles in the body is an important treatment in this DCS. Oxygenation by nasal cannula in early stage and hyperbaric oxygenation in sever conditions are common treatments. ECMO can remove nitrogen bubbles of the blood and body and decrease concentration of nitrogen in the blood, and furthermore, improves oxygenation. Conclusion: To rescue and prevent death in DCS victims, it is required to consider appropriate measures by minimum side effects. To do so, veno-venous ECMO can be a safe technique. The studies conducted in this field are limited; therefore more studies about ECMO usage in DCS must be conducted.