Evidence map›Paper›PMID 31177519›Full record

SynthesisDiving and hyperbaric medicine2019

Systematic review on the effects of medication under hyperbaric conditions: consequences for the diver.

Erik Hoencamp, Thijs Tcf van Dongen, Pieter-Jan Am van Ooij, Thijs T Wingelaar, Mees L Vervelde, Dave Aa Koch, Rob A van Hulst, Rigo Hoencamp

Open access · greenAbstract readSystematic Review
In one paragraph

Synthesis in Diving and hyperbaric medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Medical care in submarine accidents.Critical care (London, England) · 2026
    Review
  2. Review
  3. SCUBA Diving in Adult Congenital Heart Disease.Journal of cardiovascular development and disease · 2023
    Review
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Erik HoencampInstitute of Psychology, Leiden University, Leiden, The Netherlands.
Thijs Tcf van DongenDefense Healthcare Organization, Ministry of Defense, Utrecht, The Netherlands.
Pieter-Jan Am van OoijDiving Medical Center, Royal Netherlands Navy, Den Helder, The Netherlands.
Thijs T WingelaarDiving Medical Center, Royal Netherlands Navy, Den Helder, The Netherlands.
Mees L VerveldeCentral Military Hospital, Ministry of Defense, Utrecht.
Dave Aa KochDiving Medical Center, Royal Netherlands Navy, Den Helder, The Netherlands.
Rob A van HulstDiving Medical Center, Royal Netherlands Navy, Den Helder, The Netherlands.
Rigo HoencampDefense Healthcare Organization, Ministry of Defense, Utrecht, The Netherlands.
Ministry of Defence · NLAcademic Medical Center · NLLeiden University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPhysiological changes are induced by immersion, swimming and using diving equipment. Divers must be fit to dive. Using medication may impact the capacity to adapt to hyperbaric conditions. The aim of this systematic review is to assess the interaction of diving/hyperbaric conditions and medication and to provide basic heuristics to support decision making regarding fitness to dive in medicated divers.

methodsThis was a systematic review of human and animal studies of medications in the hyperbaric environment. Studies were subdivided into those describing a medication/hyperbaric environment interaction and those concerned with prevention of diving disorders. Studies without a relation to diving with compressed air, and those concerning oxygen toxicity, hyperbaric oxygen therapy or the treatment of decompression sickness were excluded.

resultsForty-four studies matched the inclusion criteria. Animal studies revealed that diazepam and valproate gave limited protection against the onset of the high-pressure neurological syndrome. Lithium had a protective effect against nitrogen-narcosis and losartan reduced cardiac changes in repetitive diving. Human studies showed no beneficial or dangerous pressure-related interactions. In prevention of diving disorders, pseudoephedrine reduced otic barotrauma, vitamins C and E reduced endothelial dysfunction after bounce diving and hepatic oxidative stress in saturation diving. DISCUSSION AND

conclusionsAnimal studies revealed that psycho-pharmaceuticals can limit the onset of neurologic symptoms and cardiovascular protective drugs might add a potential protective effect against decompression sickness. No evidence of significant risks due to changes in pharmacologic mechanisms were revealed and most medication is not a contraindication to diving. For improving decision making in prescribing medicine for recreational and occupational divers and to enhance safety by increasing our understanding of pharmacology in hyperbaric conditions, future research should focus on controlled human studies.

Indexed as

Decompression SicknessDivingHyperbaric OxygenationInert Gas NarcosisAnimalsHumansSwimmingDecompression sicknessDivingDrugsFitness to divePharmacokineticsReview article

Identifiers

PMID31177519
PMCPMC6704002
OpenAlexW2951866772

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.