Scientific papers 2014 - 2015
The documents are classified chronologically from 2014 to 2015.
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This report can be considered a Key study regarding gas
consumption in an emergency and is taken as a reference
in the publications CCO Ltd and Diving & ROV specialists
regarding the calculation of the range offered by bailouts.
This document can be downloaded from our server by
clicking on the picture of the cover, or from the UK HSE
server by clicking on the text.
UK HSE address: hse.gov.uk/research/rr1073
Bruce Wienke (1940 - 2020) was the Program Manager in
the United States of America Nuclear Weapons
Technology Simulation And Computing Office at the Los
Alamos National Laboratory. He worked on
decompression, gas transport, and phase mechanics.
He published numerous documents related to
decompression models and contributed to many
workshops. He also developed algorithms for
decompression computers, notably those used by the
brand “Suunto”.
In this article, he made a status of the existing
decompression models used for diving applications and
their impact on these activities.
Magnetic Resonance Imaging (MRI) is currently the most
accurate neuroimaging technique available for detecting
brain and spinal cord lesions in neurologic type 2
decompression sickness.
Some typical results are summarized and illustrated in this
article.
Also, the authors review the limitations of previous work
and make practical methodologic suggestions for future
neuroimaging studies.
Authors:
Antonino Baez, Joseph Shiloach, Tadeusz Doboszynski.
The response of bacteria, yeast, and mammalian and
insects cells to oxidative stress is a topic that has been
studied for many years. However, in most reported
studies, the oxidative stress was caused by challenging the
organisms with H2 O2 and redox-cycling drugs but not
by subjecting the cells to high concentrations of
molecular oxygen. In this review, the authors summarize
the available information about the effect of elevated
oxygen concentrations on the physiology of
microorganisms and cells at various culture conditions.
Authors: Jacek Kot & Zdzislaw Sicko
Most operational procedures rely on experimentally found
parameters describing a continuous slow decompression
rate. In Poland, the system for programming continuous
decompression after saturation with compressed air and
nitrox has been developed based on the Extended
Oxygen Window (EOW) concept. EOW mainly depends
on the physiology of the metabolic oxygen window, also
called inherent unsaturation or partial pressure vacancy,
but also on the metabolism of carbon dioxide, the
existence of water vapor, as well as tissue tension.
Ultrasonic techniques allow the visualisation of
microbubbles in the heart and blood vessels after diving.
Techniques to detect bubbles include Continuous Wave
Doppler, Transthoracic Echocardiography, Pulsed
Doppler Detection, and Transesophageal
Echocardiography.
Counting and grading the number of bubbles following
diving is a powerful tool to validate current dive tables
and algorithms, assess the effect of different
preconditioning techniques, and therefore increase diving
safety.
There are different counting and scoring scales to
categorize bubble quantities.
Although useful for research applications, bubble
counting has limitations in clinical application and,
therefore doubtable diagnostic value for the individual
DCS risk assessment.
Authors: Danilo Cialoni, Massimo Pieri, Costantino
Balestra, and Alessandro Marroni,
Introduction:
Flying after diving may increase decompression sickness
risk (DCS), but strong evidence indicating minimum
prefight surface intervals (PFSI) is missing.
Methods:
On return flights after a diving week on a live-aboard, 32
divers were examined by in-flight echocardiography with
the following protocol: outgoing flight, no previous dive;
during the diving week; before the return flight after a 24-
h PFSI; and during the return flight.
Authors:
Lesley Blogg, Mikael Gennser, Andreas Møllerløkken, and
Alf O Brubakk
Introduction:
Diving often causes the formation of ‘silent’ bubbles upon
decompression. If the bubble load is high, then the risk of
decompression sickness (DCS) and the number of
bubbles that could cross to the arterial circulation via a
pulmonary shunt or patent foramen ovale increase.
Bubbles can be monitored aurally, with Doppler
ultrasound, or visually, with two-dimensional (2D)
ultrasound imaging. Doppler grades and imaging grades
can be compared with good agreement. Early 2D
imaging units did not provide such comprehensive
observations as Doppler, but advances in technology
have allowed the development of improved, portable,
relatively inexpensive units. Most now employ harmonic
technology; it was suggested that this could allow
previously undetectable bubbles to be observed.
Authors: David J. Doolette, Keith A. Gault, wayne A. Gerth
Heliox (He-O2 ) enables diving deeper than limits imposed
by breathing N2-O2, but heliox has some costs, and
several navies have pursued a trimix (He-N2-O2) diving
capability as an alternative to heliox. It is widely believed
that trimix bounce dives can be conducted with
substantially reduced decompression times than
corresponding heliox dives. If this were true, trimix would
be an attractive alternative to heliox for U. S. Navy MK 16
MOD 1 underwater breathing apparatus (UBA) diving.
However, there is no direct evidence of greater
decompression efficiency of trimix than of heliox.
Authors:
Emmanuel Gempp, Pierre Louge, Sébastien De Maistre,
Loïc Emile and Jean-Eric Blatteau.
Neuron-specific enolase (NSE) and S100B protein are
brain-origin proteins commonly described to assess the
presence and severity of the neurological injury. To date,
limited data are examining the influence of scuba diving
on these biomarkers, particularly when symptoms of
decompression sickness (DCS) occur. The purpose of this
controlled study was to determine whether these serum
neurochemical markers could be used as indicators of
neurological DCS and predictors of incomplete recovery.
Authors
Dror Tal, Hofit Shachar-Bener, Dov Hershkovitz, Yehuda
Arieli, & Avi Shupak
Mass stranding of cetaceans (whales and dolphins), in
close association with the activity of naval sonar systems,
has been reported on numerous occasions. Necropsy
showed associated bubble lesions similar to those
described in human decompression sickness (DCS). The
authors examined the hypothesis that exposure to
underwater sound may potentiate DCS.
Authors:
Abu Shamsuzzaman, Michael J. Ackerman, Fatima Sert
Kuniyoshi, Valentina Accurso, Diane Davison, Raouf S.
Amin, and Virend K. Somers.
This study aimed to develop a simple and practical
method for simulating diving in humans using facial cold
exposure and apnea stimuli to measure neural and
circulatory responses during the stimulated diving reflex.
Authors:
Arve Lie, Marit Skogstad, Håkon A. Johannessen, Tore
Tynes, Ingrid Sivesind Mehlum, Karl-Christian Nordby, Bo
Engdahl, Kristian Tambs.
This document gives a systematic review of the
development of noise-induced hearing loss (NIHL) in
working life. It can be used as a complement to the papers
more specialized on noise harm linked to diving
operations.
Authors: Mircea Degeratu, Simona Rus, Ana Ion.
The improvement of the efficiency of diving interventions
at depths greater than 15m has brought into focus the
problem of increasing underwater working time by using
over-oxygenated synthetic breathing mixtures to optimize
the relation between working time and duration of
decompression. The “nitrox” binary mixture best meets
diving requirements at depths within the range of 15 to
50 meters.
Authors: Damien Fouan, Younes Achaoui, and Serge
Mensah.
A microbubble sizing method based on the odd
harmonics of square-like excitations is presented. The
microbubble resonance signature is determined by
measuring the backscattered signals using the Dual
Frequency Method combined with a time-frequency
representation. This method's efficiency and limitations are
described in the case of sine-like excitations.
Authors: Stephen R. Thom, Veena M. Bhopale, and Ming
Yang.
Microparticles are generated in vivo with exposures to
high-pressure gases by unclear mechanisms. As a result,
high inert gas pressure causes singlet oxygen formation,
which initiates a cycle of actin S-nitrosylation, nitric-oxide
synthase-2, and NADPH oxidase activation leading to
microparticle formation.
In conclusion, Inert gas-mediated oxidative stress causes
microparticle production, which may initiate events
leading to decompression sickness.
Authors: Virginie Papadopoulou, Meng-Xing Tang,
Costantino Balestra, Robert J. Eckersley, Thodoris
D. Karapantsios.
In contrast to decompression-induced bubbles, whose site
of initial formation and exact composition are debated,
there are other instances of bubbles in the bloodstream
which are well-defined. Gas emboli unwillingly introduced
during surgical procedures and ultrasound microbubbles
injected for use as contrast or drug delivery agents are
therefore also discussed. After presenting the different
ways that bubbles can end up in the human bloodstream,
the general mathematical formalism related to the physics
of bubble growth and detachment from decompression is
reviewed.
.
Authors: Jason M. Valadao, John A. Vigilante, Nicholas W.
DiGeorge, Sunila E. O’Connor, Alexandria Bear,
Jeffrey Kenyon, Heather Annis, Joseph Dituri,
Amy E. Dituri, Harry T. Whelan.
A ketogenic diet (KD) may decrease central nervous
system oxygen toxicity symptoms in divers. In view of this
implication, a feasibility/toxicity pilot study was performed
to demonstrate tolerance of KD while performing normal
diving profiles.
.
Authors: Sigrid Theunissen, Costantino Balestra, Antoine
Boutros, David De Bels, François Guerrero, and
Peter Germonpré
The study aimed to observe the effects of dark chocolate
on endothelial function after scuba diving.
Authors: Ran Arieli, Uri Arieli, & Abraham Marmur.
Bubbles nucleate and develop after decompression at
active spots on the luminal aspect of ovine large blood
vessels. A Series of bubbles were shown to detach from
the active spot with a mean diameter of 0.7–1.0 mm in
calm conditions. The effect of mechanical disturbance
(striking the bowl containing the vessel or tangential flow)
was studied on ovine blood vessels stretched on
microscope slides and photographed after hyperbaric
exposure.
Stephen R. Thom, Michael Bennett, Neil D. Banham,
Walter Chin, Denise F. Blake, Anders Rosen, Neal W.
Pollock, Dennis Madden, Otto Barak, Alessandro Marroni,
Costantino Balestra, Peter Germonpre, Massimo Pieri,
Danilo Cialoni, Phi-Nga Jeannie Le, Christopher Logue,
David Lambert, Kevin R. Hardy, 1Douglas Sward, Ming
Yang, Veena B. Bhopale, and Zeljko Dujic.
The authors hypothesized that the number of blood-
borne, Annexin V-positive Circulating microparticles (MPs)
and neutrophil activation, assessed as surface MPO
staining, would differ between self-contained underwater
breathing-apparatus divers suffering from DCS vs.
asymptomatic divers.
Authors
Ming Yang, Otto F. Barak, Zeljko Dujic, Dennis Madden,
Veena M. Bhopale, Jasjeet Bhullar, and Stephen R. Thom
Predicated on evidence that diving-related microparticle
generation is an oxidative stress response. This study
investigated the role that oxygen plays in augmenting the
production of annexin V-positive microparticles associated
with open-water SCUBA diving and whether elevations
can be abrogated by ascorbic acid.
Authors
C. Balestra, F. Cimino, S. Theunissen, T. Snoeck, S. Provyn, R.
Canali, A. Bonina, and F. Virgili
Nutritional antioxidants have been proposed as an
expedient strategy to counter the potentially deleterious
effects of scuba diving on endothelial function, flow-
mediated dilation (FMD), and heart function. Sixteen
volunteers performing a single standard dive (20 min at 33
m) according to US Navy diving procedures were
randomly assigned to two groups: one was administered
with two doses of 200 mg of an anthocyanin (AC)-rich
extract from red oranges, 12 and 4 h before diving.
Authors: Mircea Degeratu, Simona Rus, & Ana Ion
Improving the efficiency of interventions made with divers
at depths greater than 15m has brought into focus the
problem of increasing underwater working time by using
over-oxygenated synthetic breathing mixtures in order to
optimize the relation between working time and duration
of decompression. The "NITROX" binary mixture best meets
the requirements of diving at depths within the range of
15 to 50 meters. NITROX is used for depths in the range of
15 to 50 m. When this mixture is used, the decompression
time shortens and the respiratory resistance decreases.
Therefore, the use of NITROX leads to an improvement in
diving efficiency, by increasing underwater working time,
and by reducing the decompression time
Authors: Gonglin Hou, Youlan Zhang, Na Zhao, Ruiyong
Chen, Weibing Xiao, Hao Yu, Jiachun Wang, and
Ti-Fei Yuan.
The present study investigated the cognition and
performance efficacy of four divers during a simulated 480
meters helium–oxygen saturation diving. The authors
analyzed the spatial memory, 2D/3D mental rotation
functioning, grip strength, and hand–eye coordination
ability in four divers during the 0–480 m compression and
decompression processes of the simulated diving.
Author: Ronald W. Day
Pulmonary hypertension is a serious disease associated
with constriction, cellular hypertrophy and proliferation,
inflammation, and in situ thrombosis of the small vessels of
the pulmonary circulation. Patients often respond more
favorably to long-term treatment if their pulmonary
vascular resistance decreases during acute vasodilator
testing during heart catheterization.
However, the response to short acting agents may not
predict the long-term response to medications that act on
different pathways of signal transduction. The acute
hemodynamic effects of oxygen with nitric oxide and
diltiazem were not similar in a previous study
of patients with pulmonary hypertension.
Authors:
Sebastian Schulz-Stübner, Petra Zimmer, Peter Leonards
Hyperbaric oxygen therapy (HBOT) is a non-invasive
treatment that involves breathing pure oxygen in a
pressurized room or tube.
HBOT can be used for chronic wound-healing problems,
soft-tissue infections, gas gangrene, and as an emergency
treatment for diving decompression sickness or carbon
monoxide poisoning.
Multiplace hyperbaric therapeutic chambers can
accommodate several patients at once, allowing contact
among patients who may be infected or colonized.
Authors:
Pieter-Jan Van Ooij, R.A. van Hulst, W. Kulik, P. Brinkman,
A. Houtkooper, P.J. Sterk
Exhaled breath contains volatile organic compounds
(VOCs) associated with respiratory pathophysiology. The
authors hypothesized that hyperbaric oxygen exposure
(hyperoxia) generates a different VOC pattern.
This study aimed to test this hypothesis in oxygen-
breathing divers.
Authors:
Antonio Ayala, Mario F. Muñoz, and Sandro Argüelles
Lipid peroxidation can be described as a process under
which oxidants such as free radicals attack lipids
containing carbon-carbon double bond(s), especially
polyunsaturated fatty acids. Extensive literature regarding
lipid peroxidation has shown its essential role in cell
biology and human health. Discoveries about the
involvement in cellular physiology and pathology, as well
as the control of lipid peroxidation, continue to emerge
every day.
Publisher: Undersea and Hyperbaric Medical Society
This document from the Undersea and Hyperbaric
Medical Society , published in 2014, provides guidance
and support for scientists and practitioners of hyperbaric
oxygen therapy.
Authors:
Syeda Rubina Gilani, Madiha Batool, Syed Raza Ali Zaidi,
Zaid Mahmood, Amanat Ali Bhatti, and Arjumand Iqbal
Durrani
This study explains the chronic effect of heavy toxic metals
on the nervous system.
During experimentation, rabbits used as laboratory
animals were given test metals in their diet. The
concentration of metals given to them in the diet was less
than their tolerable dietary intake. Behavioral changes
were observed during experimentation. A periodic
increase in the metal concentration was seen in the blood
sample of rabbits.
Author: Tuomo T. Tompuri
Physical activity refers to any bodily movements produced
by skeletal muscles that expends energy. Hence the
amount and the intensity of physical activity can be
assessed by energy expenditure. Metabolic equivalents of
task (MET) are multiplies of the resting metabolism
reflecting metabolic rate during exercise. The standard
MET is defined as 3.5 ml/min/kg. However, the expression
of energy expenditure by body weight to normalize the
size differences between subjects causes analytical
hazards: scaling by body weight does not have a
physiological, mathematical, or physical rationale.
This review demonstrates that a false methodology may
cause paradoxical observations.
Authors: Barbara E. Shykoff
A two-part residual oxygen time model predicts the
probability of detectible pulmonary oxygen toxicity P(P[O 2
tox]) after dives with oxygen partial pressure (PO2) of
approximately 130 kPa and provides a tool to plan dive
series with selected risk of P[O2 tox]. Data suggest that
pulmonary oxygen injury at this PO2 is additive between
dives. Recovery begins after a delay and continues during
any following dive.
Authors:
Romuald Olszanski, Piotr Radziwon, Jolanta Korsak, Piotr
Siermontowski, Mariusz Kozakiewicz
Gas bubbles occurring during decompression create a
non-physiological surface that comes into contact with
blood platelets and coagulation proteins. The result is the
activation of blood platelets and contact factors.
Accordingly, over 30 years ago, Polish researchers began
verifying the safety of decompression tables by evaluating
changes in homeostasis and fibrinolysis.
Authors:
Claire Masterson, Gail Otulakowski, and Brian P. Kavanagh
Multiple clinical and laboratory studies have been
conducted to illustrate the effects of hypercapnia in a
range of injuries, and to understand the mechanisms
underlying these effects. The aim of this review is to
highlight and interpret information obtained from these
recent reports and discuss how they may inform the
clinical context.
Authors:
Martyna Krukowska, Katarzyna Janczuk, Anna Slifirczyk,
Marta Kowalenko
Pulmonary barotrauma consists in the damage of
pulmonary tissues resulting from pressure differences in
the body and the surroundings.
Barotrauma may occur during diver's ascent with a held
breath.
Objective: Presentation of symptoms in divers performing
dives at shallow depths. A detailed description of
pulmonary barotrauma as a direct hazard to life. Rescue
procedure in the case of an occurrence of pulmonary
barotrauma, methods of prevention.
Authors:
Denise F. Blake, Derelle A. Young, and Lawrence H.
Brown
Hyperbaric nursing has become a specialty requiring high
skill and knowledge. Nitrogen narcosis is a perceived risk
for all inside hyperbaric chamber nurses. The actual
degree of impairment at pressure has not been quantified.
Twenty eight subjects participated in the study.
Sixteen hyperbaric nurse candidates and five experienced
hyperbaric nurses completed Trail Making Test A (TMTA)
pre and post compression and at 180 kPa and 300 kPa.
Authors:
Christopher Matthew Norton Earing, Damian John
McKeon, Hans-Peter Kubis
Two studies were performed to investigate the ventilatory
response to CO 2 in hyperoxia, hypoxia, and during
exercise amongst experienced scuba divers and matched
controls.
The first investigated the CO2 sensitivity in rest and
exercise using CO2 rebreathing in hyperoxia at a
workload typical for diving with divers and controls. The
second study examined the respiratory drive of divers and
controls whilst breathing four different gas mixtures
balanced with N2 to assess the combined response to
hypercapnia and moderate hypoxia.
Authors: Richard E. Moon, Simon Mitchell
The use of oxygen with pressure to accelerate gas
diffusion and bubble resolution in humans was first
suggested in 1897 and eventually tested in the 1930s for
human DCS and recommended for treatment of divers.
It is also likely that hyperbaric O2 has other beneficial
pharmacological effects such as a reduction in neutrophil
adhesion to the capillary endothelium.
The efficacy of hyperbaric O2 is now widely accepted,
and is the main stay of treatment for this disease.
Authors: J.C. Rostain, N. Balon
Compressed air or a nitrogen-oxygen mixture produces
from 0.3MPa nitrogen narcosis. The traditional view was
that anaesthesia or narcosis occurs when the volume of a
hydrophobic site is caused to expand beyond a critical
amount by the absorption of molecules of a narcotic
gas. The observation of the pressure reversal effect on
general anaesthesia has for a long time supported the
lipid theory. However, recently, protein theories are in
increasing consideration since results have been
interpreted as evidence for a direct anaesthetic-protein
interaction.
Authors: Guillaume Costalat, Aurélien Pichon, Fabrice
Joulia, Frédéric Lemaître
Although it has been demonstrated that the exponential
decay model fits the heart rate kinetics in short static
breath holding, this model might be inaccurate when
breath is maintained for several minutes. The aim of this
study was to build a new meaningful model to quantify
heart rate kinetics during prolonged static breath holding.
Authors:
Jacek Kot, Zdzislaw Sicko, Tadeusz Doboszynski
Saturation decompression is a physiological process of
transition from one steady state, full saturation with inert
gas at pressure, to another one: standard conditions at
surface. It is a delicate and long lasting process during
which single milliliters of inert gas are eliminated every
minute, and any disturbance can lead to the creation of
gas bubbles leading to decompression sickness (DCS). In
Poland, the system for programming of continuous
decompression after saturation with compressed air and
nitrox has been developed as based on the con-
cept of the Extended Oxygen Window (EOW).
Authors: Simon J Mitchell, & David J Doolette
A large right-to-left shunt (usually a persistent foramen
ovale) is found in a disproportionate number of DCS cases,
suggesting that shunted venous gas emboli (VGE) cause
injury to the inner ear. However, this seems an incomplete
explanation for the relationship between inner-ear DCS
and right-to-left shunt. The brain must concomitantly be
exposed to larger numbers of VGE, yet inner ear DCS
frequently occurs in the absence of cerebral symptoms.
This may be explained by slower inert gas washout in the
inner ear than in the brain. Thus, there is a window after
surfacing within which VGE arriving in the inner ear (but
not the brain) would grow due to inward diffusion of
supersaturated inert gas.
