Scientific papers 2009
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.
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.
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.
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.
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.
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.
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.
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.
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
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
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
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.
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.
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.
Authors: J H Breedjik, G J G M Van Der Putten, L M
Schrier, W Sterk
Hyperbaric work was conducted for constructing an
underground tramway in the Netherlands. A total of
11,647 exposures were conducted in 41,957 hours. For
these working conditions, specifically developed
decompression tables were used. Fifteen workers were
submitted to Doppler monitoring after caisson work at a
depth at I 2 msw. Measurements were done according to
the Canadian DCIEM protocol. For bubble grading, the
Kisman-Masurel 12-point ordinal scale (0-IV) was used.
Authors: Frederik Kragerud Goplen, Marit Grønning,
Torbjørn Aasen, and Stein Helge Glad Nordahl
Divers occasionally suffer vestibular injuries due to
barotrauma or decompression illness (DCI). Acute cases
are typically identified by a combination of vertigo,
nausea, and vomiting, with a tendency to fall to the
injured side and nystagmus to the contralateral side. The
loss of peripheral vestibular function may be permanent,
but in spite of this, there is often nearly complete
symptomatic recovery after weeks to months due to
central vestibular compensation.
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Authors:
Richard D. Vann, Petar J. Denoble, Laurens E. Howle, Paul
W. Weber, John J. Freiberger, & Carl F. Pieper
The authors examined how decompression illness is
categorized. Instead of broad classifications like Type 1 and
Type 2, they now focus on specific symptoms. They use
scoring systems for symptoms, check how they relate to
lingering effects, and use statistical methods to find
patterns over time. This method handles various types of
data and incomplete cases, aiding in the comprehension
of the most effective treatments and the severity of the
illness might be.
Authors: Jean-Michel Pontier, François Guerrero, and
Olivier Castagna
This study examined whether intensive scuba dive training
would reduce bubble formation and modulate
endothelial function as shown by skin circulation.
The results highlight that repeated scuba dives and
regular physical exercise activity reduce bubble formation
and probably protect against DCS risk.
Although this phenomenon has been observed for
decades, the mechanism remains complex, and the results
cannot elucidate the effects of physical exercise and NO
production. Bubble formation could activate the stress
response, which could be the basis for diving
acclimatization.
Authors: Frédéric Lemaître, Daniel Carturan, Claire Tourny
Chollet, and Bernard Gardette
Doppler ultrasonic detection of circulating venous bubbles
after a scuba dive is a useful indicator of decompression
safety in adults, as there is a documented relationship
between bubbles and the risk of decompression sickness.
The aim of this study was to determine whether bubbles
would be detected in children who performed a single
dive without modifying their diving habits. The results
showed that venous bubbles were not detected in
children during a typical shallow diving session.
Authors: P David Cooper, Corry Van den Broek, David R
Smart, Ron Y Nishi and David Eastman
To evaluate the decompression stress experienced by
hyperbaric nursing and medical staff and gather
demographic insights, Doppler assessments were
conducted on 28 personnel at 20-minute intervals for up
to 120 minutes after exposure. The results showed that
68% of the exposures were classified with a low Kisman-
Masurel grade, 22% with an intermediate grade, and 10%
with a high grade. Trends toward higher bubble grades
were observed among female staff members and with
increasing age, weight, and exposure frequency. No
cases of clinical decompression sickness were reported.
Authors:
Martin DJ Sayer, John AS Ross and Colin M Wilson
Researchers analyzed two datasets from Scotland to
examine trends in treating diving-related illnesses and the
impact of initial treatment on divers' conditions upon
referral and discharge. The study found that 90-92% of
divers received standard or modified Royal Navy
Treatment Table 62 or US Navy Table 6 as their primary
treatment. About 32% of divers were in severe condition
upon admission, but only 4% remained in severe
condition at discharge. The analysis suggests that using
shorter and shallower treatment tables as the initial
treatment could result in worse outcomes.
Authors: Frederic Lemaitre, Andreas Falhman, Bernard
Gardette, & Kiyotaka Kohshi
Although it is commonly believed that the risk of
decompression sickness is almost non-existent during a
single breath-hold dive, engaging in multiple breath-hold
dives with brief intervals on the surface could increase the
risk for both humans and marine mammals. For instance,
neurological issues and non-pathogenic bubbles have
been observed in breath-hold divers. Marine mammals,
which may have naturally higher nitrogen levels, might
face risks when altering their diving behaviors.
Adaptations, such as pulmonary shunts or lung collapse in
deep dives, may help mitigate these risks.
Authors:
Siri Waage, Bente Elisabeth Moen, Ståle Pallesen, Hege R.
Eriksen, Holger Ursin, Torbjørn Åkerstedt, Bjørn Bjorvatn
The purpose of this document is to provide information
about the affiliations of various departments and research
centers associated with the University of Bergen in
Norway and the Karolinska Institutet in Sweden. It lists the
specific departments and research centers, along with
their locations, indicating a collaborative or multi-
institutional context.
Authors: Ulrik Wisloff, Oyvind Ellingsen, and Ole J. Kemi
This document presents and supports the hypothesis that
high-intensity aerobic interval training leads to more
significant beneficial heart adaptations compared to low-
to-moderate exercise intensity. The text also aims to discuss
the cellular and molecular mechanisms underlying
myocardial adaptation to exercise training, referencing
recent epidemiological, experimental, and clinical studies
to support the hypothesis.
Authors:
Yasushi Mio, Yon Hee Shim, Ebony Richards, Zeljko J.
Bosnjak, Paul S. Pagel, & Martin Bienengraebe
The paper presents a scientific study investigating the
mechanisms behind xenon-induced cardioprotection
during ischemia/reperfusion injury in the heart. The study
aims to test the hypothesis that xenon protects the heart
by activating prosurvival signaling kinases that target
mitochondria. The text details the methods, results, and
conclusions of the experiment conducted on male Wistar
rats, highlighting the significant findings that support the
hypothesis.
Authors:
Asna Marinovic, Marko Ljubkovic, Ante Obad, Darija
Bakovic, Toni Breskovic, and Zeljko Dujic
The purpose of this document is to present the results of a
scientific study investigating the cardiovascular effects of
trimix dives compared to air dives. The purpose of the
study was to determine how these dives affect
cardiovascular function, with a specific focus on left
ventricular systolic function and pulmonary artery pressure,
and whether repeated dives over consecutive days have
cumulative effects. The results showed that both trimix and
air dives significantly affected cardiovascular function, but
no cumulative effects or signs of acclimatization were
observed.
Authors:
Loic Doeuvre, Laurent Plawinski, Florence Toti and
Eduardo Angles-Cano
This paper aims to inform the reader about the role and
significance of microparticles (MPS) in various
physiological and pathological contexts. It explains how
MPS are formed, their sources, and their procoagulant
activity, which is linked to several diseases. Additionally,
the text highlights the emerging role of MPS as
biomarkers for tissue activation or damage, particularly in
neurovascular conditions, and suggests their potential use
in disease prediction, diagnosis, prognosis, and follow-up.
Authors:
Eliana Lucchinetti, Johannes Wacker, Christian Maurer,
Marius Keel, Luc Harter, Kathrin Zaugg, Michael Zaugg
This paper presents the findings of a scientific study that
investigated the effects of helium inhalation on
endothelial function and inflammatory markers in humans
following ischemia-reperfusion of the forearm. The study
aimed to determine whether helium could provide
protection against postocclusive endothelial dysfunction.
The results showed that while helium inhalation reduced
certain inflammatory and procoagulant markers, it did not
improve endothelial function as measured by hyperemic
reactions.
Authors: Hideki Tamaki, kiyotaka kohshi, Shuichi sajima,
junichiro Takeyama, Takashi nakamura, Hideo
ando, Tatsuya Ishitake
This study reports a medical case study of a Japanese
male professional breath-hold diver who developed
neurological disorders, including sensory numbness and
double vision, after repetitive deep dives. The report
highlights the potential risks and dangers associated with
repetitive deep breath-hold diving with short surface
intervals, suggesting that such activities can lead to serious
and possibly fatal health issues, such as cerebral infarcts.
Authors: John A. S. Ross, Jennifer I. Macdiarmid, Finlay D.
Dick and Stephen J. Watt
This document presents the findings of a study comparing
hearing loss between professional divers and offshore
workers. The study aims to determine whether hearing
loss symptoms reflect physical disorders and evaluate the
effectiveness of total threshold shift assessment for
detecting noise-induced hearing loss (NIHL). The text
details the study's methodology, results, and conclusions,
highlighting that divers experience more NIHL than
offshore workers and suggesting that current guidelines
for assessing total threshold shifts may be inadequate.
Authors: Kim-Vdar Rasdal, Astrid Hjede, Andrea
Mollerloken, Nina Lundset, & Alf Ottar Brubakk
This document presents the findings of a scientific study
that investigated the effects of decompression on arterial
endothelial function in rats. The study aimed to determine
whether decompression without visible bubble formation,
as detected by ultrasound, had any impact on arterial
endothelial function. The results indicated that
decompression led to significant endothelial dysfunction
in the aorta, even in the absence of visible venous
bubbles. The study also concluded that there was no
evidence of blood-brain barrier damage or brain edema
in the rats.
Authors:
Philip D Loetsche, Jan Rossaint, Rolf Rossaint , Joachim
Weis , Michael Fries, Astrid Fahlenkamp, Yu-Mi Ryang,
Oliver Grottke, and Mark Coburn
This study presents a scientific study that investigates the
neuroprotective potential of the noble gas argon. The
study aims to determine whether argon can protect brain
cells from damage caused by traumatic brain injury and
cerebral ischemia, similar to the effects observed with
other noble gases like xenon and helium. The text outlines
the methods used, the results obtained, and concludes
that argon has shown neuroprotective effects in vitro,
warranting further in vivo animal research.
Authors: J. Hugon, L. Barthélemy, J.C. Rostain, B. Gardette
The authors of this study review and discuss the potential
formation sites and mechanisms of microbubbles detected
in the bloodstream after decompression. They explore
various hypotheses about where and how these
microbubbles form, including on the endothelium lumen
wall of capillaries, from pre-existing gas nuclei in the blood,
or within tissues. They also consider the role of the
lymphatic system in transporting these microbubbles to
the bloodstream, offering an explanation for their
detection over extended periods.
Authors: Christopher Sames, Desmond F Gorman, Simon
J Mitchell, Greg Gamble
This study investigates the long-term effects of
occupational diving on lung function in New Zealand
divers. It aims to determine changes in lung function over
a five-year period and to analyse these changes in relation
to factors such as gender, smoking status and years of
diving experience. It also discusses the significance of the
findings, potential implications for clinical relevance and
concerns about the utility of current prediction equations
for lung function monitoring in this population.
Authors: Douglas Walker, John Lippmann, Chris
Lawrence, John Houston and Andrew Fock
This paper summarizes a study conducted on diving-
related deaths in Australia in 2004. It outlines the
methodology used in the study, provides a breakdown of
the results, including the number and types of diving-
related fatalities, and concludes with observations about
contributing factors to these deaths.
Authors: Alf O Brubakk and Andreas Møllerløkken
This study discusses the challenges and mechanisms
associated with decompression in diving, mainly focusing
on the formation of gas bubbles and their impact on
endothelial function. It highlights the potential role of
endothelial dysfunction as a primary mechanism for
neurological decompression injuries and suggests that
physical exercise and nitric oxide could be novel
approaches to mitigate the risk of such injuries.
Authors: Colin M Wilson, John AS Ross and Martin DJ
Sayer
This document is an analysis and overview of treatment
protocols for emergency recompression of divers in shore-
based chambers in Scotland, specifically focusing on
saturation therapies. It aims to explain the use of two
forms of saturation therapy (heliox and air), their
principles, advantages, and considerations for their
application. Additionally, it presents case reports to
illustrate the types of situations that necessitate saturation
treatment.
Authors: Peter J Fenner and John Lippmann
The purpose of this document is to raise awareness about
the increasing presence and dangers of jellyfish stings in
Thailand, particularly for swimmers and divers. It highlights
the need for Thai authorities to implement warning
systems and prevention strategies to protect both locals
and tourists from potentially life-threatening jellyfish
encounters.
Authors: Alf O Brubakk and Andreas Møllerløkken
The authors of this paper discuss the challenges and
potential mechanisms involved in decompression injuries
related to diving, focusing on the role of vascular gas
bubbles and their impact on endothelial function. They
highlight the significance of endothelial dysfunction as a
possible primary mechanism for neurological
decompression injuries and suggest that physical exercise
and the use of nitric oxide could be novel approaches to
reducing the risk of such injuries.
