Decompression illness (DCI), a syndrome following inadequate reduction in environmental pressure, has two forms:
decompression sickness and arterial
gas embolism after pulmonary
barotrauma. Recompression
therapy using
oxygen, a kind of
hyperbaric oxygen therapy, has been considered the gold standard treatment for DCI, although there is no randomized controlled trial evidence for its use. We evaluated the effectiveness of recompression
therapy in treating DCI by reviewing the reported therapeutic results of serious DCI, especially
neurological disorders. Early or ultra-early recompression
therapy did not dramatically improve clinical recovery from DCI symptoms, including
spinal cord disorders. In contrast, early
first aid normobaric
oxygen inhalation highly improved or stabilized clinical conditions of DCI. Based on these clinical results, the international committee for hyperbaric and diving medicine has stated that cases of mild DCI may be managed without recompression
therapy. Further work is needed to clarify the clinical utility of recompression
therapy for
spinal injury as a common symptom of DCI. We also point out that the Japanese decree "Ordinance on Safety and Health of Work under High Pressure", which describes work under hyperbaric environments, has some serious issues and should be amended on the basis of scientific evidence.