Acute kidney injury caused by decompression illness successfully treated with hyperbaric oxygen therapy and temporary dialysis

摘要: A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained dyspnea, chest pain, and abdominal pain. He dove again, intending ease the symptoms, but symptoms were never relieved. a total 4 h. No neurological abnormalities observed. Computed tomography images revealed portal venous gas mesenteric gas, in addition bubbles femoral veins, pelvis, lumbar canal, intracranial sinuses, joints. Hyperbaric oxygen therapy (HBOT) immediately administered. His improved after first course HBOT, however, patient had anuria almost 36 h admission exhibited acute kidney injury (AKI). Serum creatinine creatine kinase (CK) levels increased maximal values 6.16 mg/dL 18,963 U/L, respectively. Blood flow signals not detected on Doppler ultrasound. We considered that AKI caused by blood impairment capillary leak syndrome due DCI rhabdomyolysis secondary arterial embolism skeletal muscles. Temporary dialysis required correct acidemia electrolyte disturbance. Diuretic phase initiated, put off day 3. CK returned normal 11. successfully treated without any complications. Although is rare manifestation, we should consider risk patients with severe DCI.