{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T10:20:35Z","timestamp":1778322035963,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T00:00:00Z","timestamp":1490140800000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiological Reports"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Hypovolemia is known to be a predisposing factor of decompression illness (<jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content>) while diving. The typical clinically impressive neurological symptoms of <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61\u2010year\u2010old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms. Transesophageal echocardiography showed a patent foramen ovale (<jats:styled-content style=\"fixed-case\">PFO<\/jats:styled-content>). Furthermore, the patient displayed hypotension as well as prerenal acute kidney injury with elevated levels of creatinine and reduced renal clearance, indicating a hypovolemic shock. Early hyperbaric oxygen (<jats:styled-content style=\"fixed-case\">HBO<\/jats:styled-content>) therapy reduced the neurological deficits. After volume expansion of 11 liters of electrolyte solution (1000\u00a0mL\/h) the cardiopulmonary and renal function normalized. Hypovolemia increases the risk of <jats:styled-content style=\"fixed-case\">DCI<\/jats:styled-content> during diving and that of hypovolemic shock. Early <jats:styled-content style=\"fixed-case\">HBO<\/jats:styled-content> therapy and fluid replacement is crucial for a favorable outcome.<\/jats:p>","DOI":"10.14814\/phy2.13094","type":"journal-article","created":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T01:38:46Z","timestamp":1490146726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Decompression illness with hypovolemic shock and neurological failure symptoms after two risky dives: a case report"],"prefix":"10.14814","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0012-0163","authenticated-orcid":false,"given":"Sebastian","family":"Klapa","sequence":"first","affiliation":[{"name":"Section\u00a0for Maritime Medicine Institute of Experimental Medicine Christian\u2010Albrechts\u2010University Kiel c\/o German Naval Medical Institute Kopperpahler Allee 120 Kronshagen 24119 Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Meyne","sequence":"additional","affiliation":[{"name":"Department of Neurology UKSH Campus Kiel Schittenhelmstra\u00dfe 10 Kiel 24105 Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wataru","family":"K\u00e4hler","sequence":"additional","affiliation":[{"name":"Section\u00a0for Maritime Medicine Institute of Experimental Medicine Christian\u2010Albrechts\u2010University Kiel c\/o German Naval Medical Institute Kopperpahler Allee 120 Kronshagen 24119 Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frauke","family":"Tillmans","sequence":"additional","affiliation":[{"name":"Section\u00a0for Maritime Medicine Institute of Experimental Medicine Christian\u2010Albrechts\u2010University Kiel c\/o German Naval Medical Institute Kopperpahler Allee 120 Kronshagen 24119 Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henning","family":"Werr","sequence":"additional","affiliation":[{"name":"Section\u00a0for Maritime Medicine Institute of Experimental Medicine Christian\u2010Albrechts\u2010University Kiel c\/o German Naval Medical Institute Kopperpahler Allee 120 Kronshagen 24119 Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Binder","sequence":"additional","affiliation":[{"name":"Department of Neurology UKSH Campus Kiel Schittenhelmstra\u00dfe 10 Kiel 24105 Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Koch","sequence":"additional","affiliation":[{"name":"Section\u00a0for Maritime Medicine Institute of Experimental Medicine Christian\u2010Albrechts\u2010University Kiel c\/o German Naval Medical Institute Kopperpahler Allee 120 Kronshagen 24119 Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1757-7241-21-53"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-972859"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31827e83af"},{"key":"e_1_2_7_5_1","volume-title":"Diving Medicine for Scuba Divers","author":"Gempp E.","year":"2012"},{"key":"e_1_2_7_6_1","first-page":"530","article-title":"Risks factors for recurrent neurological, decompression sickness in recreational divers: a case control study","volume":"52","author":"Gempp E.","year":"2012","journal-title":"J. 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