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Pulmonary barotrauma in SCUBA diving‑related fatalities: a histological and histomorphometric analysis

Arterial gas embolism following pulmonary barotrauma occurs in 13-24% of cases of diving deaths. The study aimed to evaluate the usefulness of a histomorphometric digital analysis in the detection of air space over-distension due to pulmonary barotrauma. The study was performed on lung parenchyma specimens of 12 divers: six had died due to arterial gas embolism following pulmonary barotrauma (mean age at death of 54 years, range of 41-61 years), and six had drowned in saltwater without a diagnosis of pulmonary barotrauma (mean age at death of 54 years, range of 41-66 years) (positive controls). For negative controls, six cases of non-SCUBA divers (mean age of death of 42 years, range of 23-55 years) who died of intracerebral haemorrhage were evaluated. No significant differences were observed in the characteristics of the air spaces between control groups (positive and negative). However, differences were observed in the area occupied by air spaces and the percentage of air space area when we compared the case group to the controls (p < 0.01); and there was a slight difference in the maximum and minimum diameters of air space (p < 0.05). The mean area occupied by air spaces and the mean percentage of air space were the most useful for discriminating pulmonary barotrauma from other causes of death (100% sensitivity and 91.7% specificity). Based on our study, inclusion of an increased pattern of air spaces as a possible diagnostic criterion for pulmonary barotrauma would be useful in discerning the cause of diving death

Springer Nature

Author: Casadesús Valbí, Josep Maria
Nieto Moragas, Javier
Serrando Querol, Maria Teresa
Boadas i Vaello, Pere
Carrera Burgaya, Ana
Aguirre, Fernando
Tubbs, R. Shane
Reina de la Torre, Francisco
Date: 2023 January 27
Abstract: Arterial gas embolism following pulmonary barotrauma occurs in 13-24% of cases of diving deaths. The study aimed to evaluate the usefulness of a histomorphometric digital analysis in the detection of air space over-distension due to pulmonary barotrauma. The study was performed on lung parenchyma specimens of 12 divers: six had died due to arterial gas embolism following pulmonary barotrauma (mean age at death of 54 years, range of 41-61 years), and six had drowned in saltwater without a diagnosis of pulmonary barotrauma (mean age at death of 54 years, range of 41-66 years) (positive controls). For negative controls, six cases of non-SCUBA divers (mean age of death of 42 years, range of 23-55 years) who died of intracerebral haemorrhage were evaluated. No significant differences were observed in the characteristics of the air spaces between control groups (positive and negative). However, differences were observed in the area occupied by air spaces and the percentage of air space area when we compared the case group to the controls (p < 0.01); and there was a slight difference in the maximum and minimum diameters of air space (p < 0.05). The mean area occupied by air spaces and the mean percentage of air space were the most useful for discriminating pulmonary barotrauma from other causes of death (100% sensitivity and 91.7% specificity). Based on our study, inclusion of an increased pattern of air spaces as a possible diagnostic criterion for pulmonary barotrauma would be useful in discerning the cause of diving death
Format: application/pdf
Document access: http://hdl.handle.net/10256/24239
Language: eng
Publisher: Springer Nature
Collection: info:eu-repo/semantics/altIdentifier/doi/10.1007/s12024-022-00567-1
info:eu-repo/semantics/altIdentifier/issn/1547-769X
info:eu-repo/semantics/altIdentifier/eissn/1556-2891
Rights: Reconeixement 4.0 Internacional
Rights URI: http://creativecommons.org/licenses/by/4.0
Title: Pulmonary barotrauma in SCUBA diving‑related fatalities: a histological and histomorphometric analysis
Type: info:eu-repo/semantics/article
Repository: DUGiDocs

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