Geriatric rehabilitation elderly people suffering after pneumonia COVID-19: emphasis on outpatient and home stage

The emergence and spread of COVID-19 infection has set health professionals the task of providing recovery and rehabilitation programs after pneumonia for patients of different age groups.The paper presents the survey results of older people after COVID-19-related pneumonia before and after one- and two-component medical rehabilitation programs.The rationality of using the proposed hypobaric chamber adaptation technique for elderly patients at the outpatient and home stages of medical rehabilitation, the effectiveness of which increased in combination with the appointment of cytoflavin, is shown.An increase of Stange test was found when combined hypobaric adaptation and kinesiotaping of the posterior arch of the diaphragm in order to create a breathing pattern in the examined group of patients. The conducted stabilometric study showed an increase in the stability of older patients after a course of hypobaric chamber adaptation.

High-altitude decompression strain can be reduced by an early excursion to moderate altitude while breathing oxygen

Recent observations suggest that development of venous gas emboli (VGE) during high-altitude flying whilst breathing hyperoxic gas will be reduced by intermittent excursions to moderate altitude. The present study aimed to investigate if an early, single excursion from high to moderate altitude can be used as an in-flight means to reduce high-altitude decompression strain. Ten healthy men were investigated whilst breathing oxygen in a hypobaric chamber under two conditions, once during a 90-min continuous exposure to a simulated cabin altitude of 24,000 ft (High; H) and once during 10 min at 24,000 ft, followed by 30 min at 15,000 ft and by 80 min at 24,000 ft (high–low–high; H–L–H). VGE scores were assessed by cardiac ultrasound, using a 6-graded scale. In H, VGE increased throughout the course of the sojourn at 24,000 ft to attain peak value [median (range)] of 3 (2–4) at min 90, just prior to descent. In H–L–H, median VGE scores were 0 throughout the trial, except for at min 10, just prior to the excursion to 15,000 ft, whence the VGE score was 1.5 (0–3). Thus, an early, single excursion from high to moderate cabin altitude holds promise as an in-flight means to reduce the risk of altitude decompression sickness during long-duration high-altitude flying in aircraft with limited cabin pressurization. Presumably, such excursion acts by facilitating the gas exchange in decompression bubbles from a predomination of nitrogen to that of oxygen.

Decompression Illness Incidence and Hypoxia Symptoms After Prebreathing in Hypobaric Hypoxia Training

INTRODUCTION: Hypobaric hypoxia training utilizing the environmental chamber is often preceded by prebreathing of 100% oxygen with the goal of reducing decompression illness (DCI). We aimed to study the impact of prebreathing 100% oxygen for 30 min prior to hypobaria exposure to 7600 m (25,000 ft) on the incidence rate of DCI, as well as the impact of prebreathing on hypoxia symptoms felt during training.METHODS: Records of participants who underwent hypobaric hypoxia training in the Republic of Singapore Air Force (RSAF) from 2011 to 2014 (before introduction of prebreathing) were compared to those who underwent similar training from 2014 to 2017 (after introduction of prebreathing) to determine the incidences of DCI for both groups. Participants who underwent hypobaric hypoxia training from January 2017 to July 2017 completed a survey to assess the impact of prebreathing on the presentation and severity of hypoxia symptoms.RESULTS: Two DCI events were recorded in 1530 hypobaric chamber exposures without prebreathing while two DCI events were recorded in 1729 exposures with prebreathing. There was no significant difference in the incidence of DCI between the two groups. The survey findings showed no significant difference in the presentation and severity of hypoxia symptoms with 30 min of prebreathing.DISCUSSION: Incidence of DCI remains low during hypobaric chamber training, with no statistical difference with or without prebreathing. Possible reasons were the short duration of hypobaric exposure of 10 min during hypoxia training, and that 30 min of prebreathing was insufficient to further decrease or eliminate the risk of DCI in short duration hypobaric exposures.Cheok LJ, Goh BLY, Soh FW, Chuan BTB. Decompression illness incidence and hypoxia symptoms after prebreathing in hypobaric hypoxia training. Aerosp Med Hum Perform. 2021; 92(5):289293.

Hyperbaric oxygen for decompression sickness: 2021 update

Hyperbaric oxygen for decompression sickness: 2021 update Decompression sickness (DCS, “bends”) is caused by the formation of bubbles in tissues and/or blood when the sum of dissolved gas pressures exceeds ambient pressure (supersaturation). This may occur when ambient pressure is reduced during: ascent from a dive; rapid ascent to altitude in an unpressurized aircraft or hypobaric chamber; loss of cabin pressure in an aircraft [2]; and during space walks. In diving, compressed-gas breathing is usually necessary, although occasionally DCS has occurred after either repetitive or very deep breath-hold dives

THE EFFECT OF THE ALTITUDE ZONE ON COGNITIVE FUNCTION FOR MALE PILOTS IN INDOCTRINATION AND AEROPHYSIOLOGY TRAINING IN 2019

Objective: A pilot on duty at altitude can be exposed to hypoxia, both mild and severe. The incidence of hypoxia on a flight can be fatal, especially if hypoxia is experienced by a pilot on duty. One manifestation of hypoxia is decreased cognitive function. A pilot is required to carry out multitasking operations using cognitive functions, especially in an emergency. Therefore, decreased cognitive function due to hypoxia in a pilot can cause accidents in flight. This study aims to determine changes in cognitive function with hypoxia exposure at several altitude zones. Methods: This study used an experimental one-group pretest-posttest design. The subjects were 31 military pilots who participated in Indoctrination and Aerophysiology Training. Subjects filled 6 Cognitive Impairment Test (6 CIT) questionnaires at ground level, efficient physiological zone (10,000 ft), and physiological deficient zone (25,000 ft) in a hypobaric chamber. Results: There was a change of 6 CIT score at 10.000 ft compared to ground level (Friedman post-hoc Wilcoxon, P = 0.001). There was also a change of 6 CIT score at 25,000 ft compared to ground level (Friedman post-hoc Wilcoxon, P<0.001). Conclusion: There was a change in cognitive function in the efficient physiological zone and physiological deficient zone, compared to ground level.

Hyperbaric treatment for decompression sickness: current recommendations

Rationale Decompression sickness (DCS, “bends”) is caused by formation of bubbles in tissues and/or blood when the sum of dissolved gas pressures exceeds ambient pressure (supersaturation) [1]. This may occur when ambient pressure is reduced during any of the following: • ascent from a dive; • depressurization of a hyperbaric chamber; • rapid ascent to altitude in an unpressurised aircraft or hypobaric chamber; • loss of cabin pressure in an aircraft [2] and • during space walks.

Recent changes in hypoxia training at the Royal Air Force Centre of Aviation Medicine

Hypoxia training at the Royal Air Force Centre of Aviation Medicine (RAF CAM) has traditionally involved the use of a hypobaric chamber to induce hypoxia. While giving the student experience of both hypoxia and decompression, hypobaric chamber training is not without risks such as decompression sickness and barotrauma. This article describes the new system for hypoxia training known as Scenario-Based Hypoxia Training (SBHT), which involves the subject sitting in an aircraft simulator and wearing a mask linked by hose to a Reduced Oxygen Breathing Device (ROBD). The occupational requirements to be declared fit for this new training method are also discussed.