Scientific papers 2009 - 2010
The documents are classified chronologically from 2009 to 2010. Click on their descriptions to open and download them.
Next page Next page BUTTON TEXT Previous page 13 - M. Lang & A. Brubakk: The future of diving: 100 years of haldane and beyond.
This document is an ensemble of articles from various authors that present the works of Haldane and other topics such as: Decompression physiology decompression methodology Stategic approches Environmental physiology Their authors presented them during the Baromedical and Environmental Physiology Group of the Norwegian University of Science and Technology in Trondheim, Norway, on 18–19 December 2008.
18 - Hyperbaric stress in divers and non-divers: Neuroendocrine and psychomotor responses
Authors: Tom McLellan, Heather Wright, Shan Rhind, Bruce Cameron, & David Eaton. This study compared neuroendocrine and psychomotor responses in divers (d, n=11) and non-divers (Nd, n=9) following 30-minute hyperbaric and decompression stress to 180, 300, and 450 kpa. Venous blood was drawn pre- dive and at 20 and 60 minutes post-dive and analyzed for norepinephrine (Ne), epinephrine (e), tryptophan (trp), cortisol (cor), growth hormone (gH), adrenocorticotrophic hormone (actH), and prolactin (prl). Reaction time was assessed using a psychomotor vigilance task.
4 - Jean-Eric Blatteau & Jean-Michel Pontier: Effect of in-water recompression with oxygen to 6 msw versus normobaric oxygen breathing on bubble formation in divers
It is generally accepted that the incidence of decompression sickness (DCS) from hyperbaric exposures is low when few or no bubbles are present in the circulation. To date, no data are available on the influence of in-water oxygen breathing on bubble formation following a provocative dive in man. The purpose of this study was to compare the effect of post-dive hyperbaric versus normobarc oxygen breathing (NOB) on venous circulating bubbles.
12 - Pre-dive normobaric oxygen reduces bubble formation in scuba divers. Authors: Olivier Castagna, Emmanuel Gempp, Jean-Eric Blatteau
Oxygen pre-breathing is routinely employed as a protective measure to reduce the incidence of altitude decompression sickness in aviators and astronauts, but the effectiveness of normobaric oxygen before hyperbaric exposure has not been well explored. The objective of this study was to evaluate the effect of 30-min normobaric oxygen (O2) breathing before diving upon bubble formation in recreational divers.
11 - Avid J Doolette, Wayne A Gerth, Keith A Gault: Risk of central nervous system decompression sickness in air diving to no-stop limits. 
Man-testing at the Navy Experimental Diving Unit (NEDU) of the Thalmann Algorithm VVal-18 air no-stop limits at 130, 150, and 190 feet of seawater resulted in incidents of severe central nervous system decompression sickness. A logistic model of the probability of CNS DCS in air no-stop dives from the recent NEDU man-testing and the USN primary N2-O2, data set was developed and used to produce a set of iso-risk air no-stop limits. A new parameter set (VVal-76) for the Thalmann Algorithm that produces air no-stop limits was developed.
25 - Emmanuel Gempp, Jean-Eric Blatteau: Preconditioning methods and mechanisms for preventing the risk of decompression sickness in scuba divers: A review
Scuba divers are at risk of decompression sickness due to the excessive formation of gas bubbles in blood and tissues following ascent, with potentially subsequent neurological injuries. Since nonprovocative dive profiles are no guarantor of protection against this disease, novel means are required for its prevention including predive procedures that could induce more resistance to decompression stress. In this article, the authors review the recent studies describing the promising preconditioning methods that might operate on the attenuation of bubble formation believed to reduce the occurrence of decompression sickness.
30 - High incidence of venous and arterial gas emboli at rest after trimix diving without protocol violations
Authors: Marko Ljubkovic, Jasna Marinovic, Ante Obad, Toni Breskovic, Svein E. Gaustad, and Zeljko Dujic. SCUBA diving is associated with the generation of gas emboli due to gas release from the supersaturated tissues during decompression. Gas emboli arise mostly on the venous side of the circulation, and they are usually eliminated as they pass through the lung vessels. Arterialization of venous gas emboli (VGE) is seldom reported, and it is potentially related to neurological damage and the development of decompression sickness. The goal of the present study was to evaluate the generation of VGE in a group of divers using a mixture of compressed oxygen, helium, and nitrogen (trimix) and to probe for their potential appearance in the arterial circulation.
2 - Decompression to altitude: assumptions, experimental evidence, and future directions.
Authors: Philip P. Foster, Bruce D. Butler This review discusses topics about the relationship between muscle activity, decompression, and microgravity. It also provides, in the context of altitude decompression, an overview of the role of denitrogenation, metabolic gases, gas micronuclei, stabilization of bubbles, biochemical pathways activated by bubbles, nitric oxide, oxygen, anthropometric or physiological variables, Doppler-detectable bubbles, and potential arterialization of bubbles.
3 - Risk factors and treatment outcome in scuba divers with spinal cord decompression sickness.
Authors: Emmanuel Gempp & Jean-Eric Blatteau This study was designed to determine the recompression strategy and the potential risk factors associated with the development of severe diving-related spinal cord decompression sickness (DCS). Sixty-three injured recreational divers presenting with symptoms of spinal involvement were retrospectively included. Diving information, symptom latency after dive completion, and time interval between symptom onset and hyperbaric treatment were studied. The severity of spinal cord DCS was rated numerically for both the acute event and one month later. Initial recompression treatment at 2.8 atmosphere absolute (ATA) with 100% oxygen-breathing or deeper recompression at 4 atmospheres absolute with nitrogen-oxygen or helium- oxygen breathing mixture was also noted.
9 - Effect of oxygen breathing and perfluorocarbon emulsion treatment on air bubbles in adipose tissue during decompression sickness.
Authors: T. Randsoe, and O. Hyldegaard The authors of this study hypothesize that the combined effect of normobaric oxygen breathing and intravascular PFC infusion could lead to either enhanced extravascular bubble growth on decompression due to the increased oxygen supply or that perfluorocarbon infusion could lead to a faster bubble elimination due to the increased solubility and transport capacity in blood for nitrogen causing faster nitrogen tissue desaturation.
10 - Pre-dive vibration effect on bubble formation after a 30-m dive requiring a decompression stop
Authors: Peter Germonpré, Jean-Michel Pontier, Emmanuel Gempp, Jean-Eric Blatteau, Stefaan Deneweth, Pierre Lafère, Alessandro Marroni, and Costantino Balestra. The preconditioning of divers to reduce post-dive de- compression sickness (DCS) has gained increased interest in diving medical research over the last few years. The beneficial effects of physical exercise, oxygen breathing, hyperbaric exposure, heat exposure, hyper-hydration, or nitroglycerin administration before the dive are only a few examples of ongoing research. In this work, the authors investigated the effects of pre-dive whole-body vibration on post-dive bubble formation.
16 - Effect of in-water oxygen prebreathing at different depths on decompression-induced bubble formation and platelet activation.
Authors: Gerardo Bosco, Zhong-jin Yang, Guglielmo Di Tano, Enrico M. Camporesi, Fabio Faralli, Fabio Savini, Angelo Landolfi, Christian Doria, and Giorgio Fanò. The effect of in-water oxygen prebreathing at different depths on decompression-induced bubble formation and platelet activation in scuba divers was evaluated. Six volunteers participated in four diving protocols, with 2 wk of recovery between dives.
19 - Prognostic factors of spinal cord decompression sickness in recreational diving: Retrospective and multicentric analysis of 279 cases.
Authors: Jean-Eric Blatteau, E. Gempp, O. Simon, M. Coulange, B. Delafosse, V. Souday, G. Cochard, J. Arvieux, A. Henckes, P. Lafere, P. Germonpre, J.-M. Lapoussiere, M. Hugon, P. Constantin, A. Barthelemy. This study aims to determine the potential risk factors associated with the development of severe diving-related spinal cord decompression sickness (DCS).
23 - Recompression and adjunctive therapy for decompression illness: A systematic review of randomized controlled trials
Authors: Michael H. Bennett, MD, Fanzca, Jan P. Lehm, Simon J. Mitchel, Ph.D, Fanzca, Jason Wasiak. Recompression is the universally accepted standard for the treatment of decompression illness (DCI). When recompression is delayed, a number of strategies have been suggested to improve the outcome. The authors examined the effectiveness and safety of both recompression and adjunctive therapies in DCI treatment.
1 - UK - HSE - Review of diver noise exposure
Authors: T G Anthony, N A Wright, M A Evans (QinetiQ) This UK HSE document is a review of diver noise exposure encompassing diver hearing, noise sources, exposure levels, and control measures. This document, which takes into account other studies available in our database can be considered one of the most appropriate and easiest to implement. It can be downloaded from our database by clicking on the picture, or from the UK HSE website through this link: https://www.hse.gov.uk/research/rrpdf/rr735.pdf
26 - Endurance exercise immediately before sea diving reduces bubble formation in scuba divers
Authors: Olivier Castagna, Jeanick Brisswalter, Nicolas Vallee, Jean- Eric Blatteau Previous studies have observed that a single bout of exercise can reduce the formation of circulating bubbles on decompression, but, according to different authors, several hours of delay were considered necessary between the end of exercise and the beginning of the dive. The objective of this study was to evaluate the effect of a single bout of exercise taken immediately before a dive on bubble formation.
28 - Evaluation of critical flicker fusion frequency and perceived fatigue in divers after air and enriched air nitrox diving
Authors: Pierre Lafere, Ciostantino Balestra, Walker Hemelryck, Nicole Donda, Ahmed Sakr, Adel Taher, & Peter Germonpre Many divers report less fatigue following dives breathing enriched air nitrox than breathing air. A reduction of post fatigue with nitrox would suggest a pathological origin, possibly the presence of asymptomatic nitrogen bubbles in the body after a dive. The authors studied fatigue in 219 healthy divers performing either air or nitrox 32% O2 dives to 21.2 msw for 43.3 min in tropical waters. The divers were assessed before the dive and 30 to 60 minutes after surfacing.
6 - Dual-frequency ultrasound detection of stationary microbubbles in tissue.
Authors: BR Bollinger, JC Wilbur, TG Donoghue, SD Phillips, DA Knaus, PJ Magari, DL Avarenga, JC Buckey Indirect evidence suggests that microbubbles that normally exist in tissue may play a key role in decompression sickness (DCS). Their sizes and locations are unknown. Dual-frequency ultrasound (DFU) exploits bubble resonance to detect bubbles over a wide range and could potentially detect stationary tissue microbubbles. To test this capability, DFU was used to detect stationary microbubbles of known size (2-3 µm mean diameter) over a range of ultrasound pressures and microbubble concentrations
8 - Signals consistent with microbubbles detected in legs of normal human subjects after exercise
Authors: J. C. Wilbur, S. D. Phillips, T. G. Donoghue, D. L. Alvarenga, D. A. Knaus, P. J. Magari, and J. C. Buckey Exercise may produce micro-nuclei in tissue, which could serve as nucleation sites for bubbles during subsequent decompression stress. These micronuclei have never been directly detected in humans. Dual-frequency ultrasound (DFU) is a resonance-based ultrasound technique capable of detecting and sizing small stationary bubbles. The authors surveyed for bubbles in the legs of six normal human subjects (ages 28–52 yr) after exercise using DFU
22 - Free energy wells for small gas bubbles in soft deformable materials.
Author: Saul Goldman Thermodynamic expressions are derived for the system relative Gibbs free energy and the relative Gibbs free energy per bubble for all possible equilibrium bubble states that can form in a soft, slightly rigid material, initially supersaturated with a dissolved inert gas N2 . While the thermodynamic manipulations are exact, the final expressions are approximate due to an approximation made in deriving the expression for the elastic free energy of a soft material containing more than a single bubble.
29 - Microparticles initiate decompression-induced neutrophil activation and subsequent vascular injuries.
Authors: Stephen R. Thom, Ming Yang, Veena M. Bhopale, Shaohui Huang, and Tatyana N. Milovanova. Progressive elevations in circulating annexin V-coated microparticles (MPs) derived from leukocytes, erythrocytes, platelets, and endothelial cells are found in mice subjected to increasing decompression stresses. Individual MPs exhibit surface markers from multiple cells. MPs expressing platelet surface markers, in particular, interact with circulating neutrophils, causing them to degranulate and leading to further MP production.
7 - Pulmonary gas exchange in diving
Authors: R. E. Moon, A. D. Cherry, B. W. Stolp, and E. M. Camporesi Diving-related pulmonary effects are due mostly to increased gas density, immersion-related increase in pulmonary blood volume, and (usually) a higher inspired PO2. Higher gas density produces an increase in airways resistance and work of breathing, and a reduced maximum breathing capacity. An additional mechanical load is due to immersion, which can impose a static trans- respiratory pressure load as well as a decrease in pulmonary compliance. The combination of resistive and elastic loads is largely responsible for the reduction in ventilation during underwater exercise.
21 - Free radicals, antioxidants and functional foods: Impact on human health.
Authors: V. Lobo, A. Patil, A. Phatak, N. Chandra Last research about decompresion illness and the use of oxygen highlight the role of free radicals. The body generates free radicals, reactive oxygen species, and reactive nitrogen species by various endogenous systems, exposure to different physiochemical conditions, or pathological states. A balance between free radicals and antioxidants is necessary for proper physiological function. Suppose free radicals overwhelm the body’s ability to regulate them, and a condition known as oxidative stress ensues. Free radicals thus adversely alter lipids, proteins, and DNA and trigger many human diseases.
14 - Prognostic Significance of Sympathetic Nervous System Activation in Pulmonary Arterial Hypertension
Authors: Agnieszka Ciarka , Vi Doan , Sonia Velez-Roa, Robert Naeije, and Philippe van de Borne The authors of this study investigated the prognostic significance of muscle sympathetic nervous system activity in pulmonary arterial hypertension. This is another purely medical document whose conclusions can be used to understand the effect of oxygen during diving operations.
20 - Effects of hyperoxia on ventilation and pulmonary hemodynamics during immersed prone exercise at 4.7 ATA: possible implications for immersion pulmonary edema
Authors: Dionne F. Peacher, Shelly R. H. Pecorella, John J. Freiberger, Michael J. Natoli, Eric A. Schinazi, P. Owen Doar, Albert E. Boso, Aaron J. Walker, Matthew Gill, Dawn Kernagis, Donna Uguccioni, and Richard E. Moon Based on the fact that previous studies revealed a progressive increase in ventilation during prolonged immersed exercise, the authors hypothesized that this increase occurs because of the development of metabolic acidosis with a concomitant rise in mean pulmonary artery pressure and that hyperoxia attenuates this increase.
27 - Thalmann Algorithm Decompression Table Generation Software Design Document
Authors: Wayne A. Gerth The Thalmann Decompression Algorithm (EL-DCA) was developed using VVal-18 and HVal-21. The original EL- DCA was extensively modified to develop MK 16 MOD 1 N2 -O2 and He-O2 decompression tables and Submarine Rescue and Diving Recompression System Operator/Tender decompression tables. The EL-DCA was further modified and used with a modified VVal-18 parameter set, designated VVal-18M, to produce an integrated set of air diving decompression tables for Revision 6 of the U.S. Navy Diving Manual.
5 - Water-power: High pressure water jets and devastating lower limb injury
Authors: Cara Connolly, Alex Munnoch, & Fiona Hogg High-pressure water jets (HPWJ) have diverse industrial use. With pressures up to 100,000 psi (power rce/sq.inch) generated in a narrow water jet, they can be used to mine granite and cut steel. Features of soft tissue injuries caused by high-pressure water jets have been described by Tejero-Trujeque: The surface wound of a HPWJ injury may not reflect the extensive tissue damage beneath, the wound may be widely contaminated by materials driven into the wound, there is a potential for progressive oedema and inflammation, and unusual infections may occur due to micro-organisms in the water source.
17 - Barrier Function Nonlinear Optimization for Optimal Decompression of Divers.
Authors: Le Feng, Christian R. Gutvik, Tor A. Johansen, Dan Sui This paper is based on a comprehensive dynamic mathematical model of vascular bubble formation and growth during and after decompression from a dive. The model describes the underlying relationship between Venous Gas Emboli (VGE) and severe Decompression Sickness (DCS) risk. Using the Copernicus model, the diving decompression problem can be formulated as a nonlinear optimal control problem, where the objective is to minimize the total ascend time subject to constraints on the maximum number of bubbles in the pulmonary artery (also referred to as the decompression stress).
15 - The clinical utility of long-term humidification therapy in chronic airway disease
Authors: Harold Rea, Sue McAuley, Lata Jayaram, Jeffrey Garrett, Hans Hockey, Louanne Storey, Glenis O’Donnell, Lynne Haru, Matthew Payton, Kevin O’Donnell Persistent airway inflammation with mucus retention in patients with chronic airway disorders such as COPD and bronchiectasis may lead to frequent exacerbations, reduced lung function, and poor quality of life. This study investigates whether long-term humidification therapy with high-flow, fully humidified air at 37 °C through nasal cannulae can improve these clinical outcomes in this group of patients. On the diving side, this study is to be linked to the quality of breathing gases and conditions resulting from airway inflammation.
24 - Taravana: Documentation of Bubbles by Computerized Tomography
Authors: Mario Alaimo, Giuseppe Aiello, Eduardo Marino, Leila Zummo, Francesco Cappello The authors report a case of a 41-year-old expert diver who, after a series of brath hold dives (60 to 80s/dive at 20 to 24m of depth for 5 consecutive hours), experienced vertigo, ringing in the left ear, and confusion, followed by right arm paresthesia trailed by right hemi-paresis after a few minutes. After <60 minutes from the emergence of these symptoms, he was admitted to the emergency unit of our hospital with less severe clinical features, presenting only confusion and paresthesia of the right hand.