What is decompression sickness (DCS)?

Updated: Nov 16, 2020
  • Author: Emi Latham, MD, FACEP, FAAEM, UHM; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Decompression sickness (DCS) refers to symptoms caused by blocked blood supply, damage from direct mechanical effects, or later biochemical actions from suspected bubbles evolving from inert gas dissolved in blood or tissues when atmospheric pressure decreases too rapidly. [26, 27] DCS can occur after scuba diving, ascent with flying, or hypobaric or hyperbaric exposure.

DCS can be broken down into the following 3 types:

  • Type I involves musculoskeletal, skin, and lymphatic tissue, and often has accompanying fatigue.

  • Type II includes neurologic systems (either CNS or peripheral), cardiorespiratory, audiovestibular, and shock. [27]

  • Type III DCS describes a syndrome that presents with severe symptoms of DCS as well as AGE. Some of these cases can be refractory to recompression.

The bubbles causing DCS also can injure vessel endothelium, which leads to platelet aggregation, denatured lipoproteins, and activation of leukocytes, causing capillary leaks and proinflammatory events. [28, 29]

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