Systemic capillary leak syndrome secondary to decompression sickness

BMJ Case Rep. 2023 Jul 5;16(7):e253045. doi: 10.1136/bcr-2022-253045.

Abstract

Systemic capillary leak syndrome is a rare derangement of endothelial function characterised by extravasation of plasma and proteins into the interstitial space. Primary capillary leak syndrome is a rare, episodic medical illness of unknown molecular pathology while secondary capillary leak syndrome may be precipitated by any number of inflammatory and infectious syndromes. Decompression sickness, a disorder of depressurisation, has been identified as a very rare trigger. We present a structured case report of systemic capillary leak syndrome secondary to decompression sickness following deep diving, informing physicians of this potential complication. No pharmacological therapy has substantial evidence in the treatment of acute systemic capillary leak syndrome. By review of current recommendations for acute management, we also emphasise an observed positive response to judicious fluid resuscitation and an oral cyclic AMP-elevating agent (ie, terbutaline).

Keywords: Adult intensive care; Cardiovascular system.

Publication types

  • Case Reports

MeSH terms

  • Capillary Leak Syndrome* / drug therapy
  • Decompression Sickness* / complications
  • Fluid Therapy / adverse effects
  • Humans
  • Plasma
  • Terbutaline

Substances

  • Terbutaline