A case of severe multi-system decompression sickness requiring critical care, aggressive fluid resuscitation and hyperbaric oxygen therapy

An experienced recreational diver developed a severe multisystem life-threatening decompression sickness following a series of eight dives over four days, the profiles of which were all within acceptable limits. The diver had marked haemoconcentration and required large volume intravenous fluid replacement during initial treatment. Similar presentations have previously only been described following deep dives, fast ascents or where mandatory decompression had been missed. The management of this case, including the involvement of a hyperbaric unit co-located to an intensive care department, and the underlying pathophysiology are discussed.