Venous gas bubbles in breath hold divers remained a focus of researchers this year, with a notable presentation coming from Danilo Cialoni and his EDAN team1. At EUBS 2017 they presented the extension of study previously reported and described in this blog. After discovering post-dive VGE in one breath hold diver, they studied VGE in 37 elite breath hold divers during their training in 42 meter deep pool with water temperature of 32 oC.
EUBS 2017 has left us with more questions than answers, on the topic of post-dive bubbles.
Ballestra presented the preliminary results of an exploratory study of the effects of sonic vibrations on post-dive venous gas emboli detected by transthoracic echocardiography1. (more…)
Recompression treatment and hyperbaric oxygen (HBOT) are standard treatment for decompression illness. While it is generally accepted that sooner recompression is associated with better outcomes, the urgency of treatment may not be same for all cases. Looking for practical guidelines we regularly consult published case series. Three case series presented at EUBS 2017 may be used to illustrate problems with such approach. (more…)
Decompression sickness is caused by gas bubbles that form in the body during and after decompression. The current thought is that gas bubbles originate on the venous side and pass to the arterial side either through intra-cardiac (PFO) or intra-pulmonary shunt (arteriovenous anastomoses). A group of scientists proposed recently a third mechanisms: the evolution of bubbles in the distal arteries, independent of venous gas bubbles.(1) They presented their work at the EUBS 2017 meeting (2) in Ravenna. (more…)
Historically, alcohol was used to treat bends in Greek sponge divers. In the late 1980s attempts to verify the possible beneficial effects of ethanol on prevention of DCS led to prevailing opinions that there was no proven benefit and that divers should not drink and dive. On the other hand, the assumption that wine drinking has beneficial effects on general health is still propagated. (more…)
Office of Naval Research 2014
While vacationing in Croatia, I heard a story about a diver who fits the description of people I sometimes call “robo-divers.” The story’s hero is a famous Croatian sponge diver, with whom I share an acquaintance. My friend, who is one of his teammates, described this robo-diver’s practice, which is similar to previously described empirical dive practices of other local sponge divers: Reportedly, he does four descents per day to extreme depths, after each of which he ascends very slowly without decompression stops. After the last dive of the day, he quickly takes his boat to shallow waters (within approximately 10 minutes) and descends for about two hours of decompression, split between stops at nine, six and three meters (30, 20 and 10 feet).
I don’t know about his decompression sickness history, but I do know that he is 64 years old now, and the fact that he has survived this long following those types of dive practices make me think of him more as a robot than as a man of flesh and bone. At very least, it is unlikely that this diver has a PFO.
Last April, a Canadian woman named Stacey Yepes experienced stroke symptoms, but by the time she made it to the hospital her symptoms were gone. Because her physicians could not find any signs of stroke, they believed that she was displaying symptoms of stress and released her home. A few days later, she had a similar attack and used her phone to tape herself during an episode in which she suffered from facial drooping and slurred speech. The video helped her doctors diagnose her with TIA (transient ischemic attack).
In many cases of diseases with transitory symptoms, physicians are unable to diagnose patients and opportunities for early treatments are missed. In the case of TIA, it is especially important to establish an early diagnosis and provide treatment to prevent the progression of symptoms and permanent loss of brain tissue. TIA can lead to blood clotting in the brain, but early administration of thrombolytic medication can prevent clotting and brain damage. Because of the transitory nature of TIA symptoms, some hospitals offer stroke telemedical consultations to enhance diagnosis of and establish early eligibility for thrombolytic medication. By using video connections, they establish a correct diagnosis in 96% of cases, as compared with only 83% of cases in which symptoms are only reported by phone.
During the ONR-NAVSEA Progress Review Meeting that took place in Durham from July 15-17 this summer, Stephen Thom summarized the current status of his research on circulating microparticles (MPs), which are small fragments shed by various cells that have been exposed to stress. These MPs can be found in subjects with inflammation or injury and in divers after diving.
Obesity has been long considered a risk factor for decompression sickness (DCS). It has been based on findings in animal studies and epidemiological data in military diving. There was no data to confirm the same effects of obesity on incidence of DCS in recreational diving; however, there were some studies indicating a positive correlation between body mass index (BMI) and likelihood of venous gas emboli (circulating gas bubbles) after dive.
In a recent paper, Kaczerska D, et al. The influence of high-fat diets on the occurrence of decompression stress after air dives. UHM 2013;40(6):487-497, intended to test possible effects of high fat intake on risk of DCS.