PMID: 30028916Jul 22, 2018Paper

The Gradient Perfusion Model Part 2: Substantiation of the GPM with clinical cases

Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc
Michael B StraussStuart S Miller

Abstract

In Part 1 of this three-part series, we provided an explanation as to why and at what sites decompression sickness (DCS) occurs, using the Gradient-Perfusion Model (GPM). In this part, we provide information to substantiate the concept and present clinical cases that were initially labeled as "unexplained DCS," but later disordering events were identified to explain the clinical presentations. Among 500 cases of DCS we have managed for over 50 years, a cohort of these patients was initially diagnosed as unexplained DCS. However, some have shown that disordering events are the likely cause of their DCS. By pairing the tissue involved with the patient's dive history, a gradient-perfusion imbalance connection was identified. In all serious (Type 2) presentations of DCS, alterations in perfusion of the fast tissues were able to account for the clinical findings. The consequences demonstrated that the gradients overwhelmed the ability of altered perfusion to offgas/offload the inert gas. Pain-only and peripheral neuropathy presentations involved both intermediate and slowly perfused tissues. Rather than perfusion, gradient limitations were the reasons for the clinical presentations of these patients. The GPM accounts for signs and s...Continue Reading

Related Concepts

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.

Related Papers

Undersea & Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc
Michael B StraussStuart S Miller
Singapore Medical Journal
J HowC Edmonds
Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association
A Erde, C Edmonds
© 2022 Meta ULC. All rights reserved