Danilo Cialoni1, Massimo Pieri2, Costantino Balestra3, Alessandro Marroni2. 1. DAN Europe Research Division, Contrada Padune 11, 64026 Roseto degli, Abruzzi (TE), Italy, Phone: +39(0)85-893-0333, Fax: +39-(0)85-893-0050, E-mail: dcialoni@daneurope.org. 2. DAN Europe Research Division, Roseto degli Abruzzi, Italy. 3. DAN Europe Research Division, Roseto degli Abruzzi, Italy, Environmental, Occupational and Ageing Physiology Lab, Haute Ecole Paul Henri Spaak, Brussels, Belgium.
Abstract
INTRODUCTION: Inert gas accumulated after multiple recreational dives can generate tissue supersaturation and bubble formation when ambient pressure decreases. We hypothesized that this could happen even if divers respected the currently recommended 24-hour pre-flight surface interval (PFSI). METHODS: We performed transthoracic echocardiography (TTE) on a group of 56 healthy scuba divers (39 male, 17 female) as follows: first echo--during the outgoing flight, no recent dives; second echo--before boarding the return flight, after a multiday diving week in the tropics and a 24-hour PFSI; third echo--during the return flight at 30, 60 and 90 minutes after take-off. TTE was also done after every dive during the week's diving. Divers were divided into three groups according to their 'bubble-proneness': non-bubblers, occasional bubblers and consistent bubblers. RESULTS: During the diving, 23 subjects never developed bubbles, 17 only occasionally and 16 subjects produced bubbles every day and after every dive. Bubbles on the return flight were observed in eight of the 56 divers (all from the 'bubblers' group). Two subjects who had the highest bubble scores during the diving were advised not to make the last dive (increasing their PFSI to approximately 36 hours), and did not demonstrate bubbles on the return flight. CONCLUSIONS: Even though a 24-hour PFSI is recommended on the basis of clinical trials showing a low risk of decompression sickness (DCS), the presence of venous gas bubbles in-flight in eight of 56 divers leads us to suspect that in real-life situations DCS risk after such a PFSI is not zero.
INTRODUCTION: Inert gas accumulated after multiple recreational dives can generate tissue supersaturation and bubble formation when ambient pressure decreases. We hypothesized that this could happen even if divers respected the currently recommended 24-hour pre-flight surface interval (PFSI). METHODS: We performed transthoracic echocardiography (TTE) on a group of 56 healthy scuba divers (39 male, 17 female) as follows: first echo--during the outgoing flight, no recent dives; second echo--before boarding the return flight, after a multiday diving week in the tropics and a 24-hour PFSI; third echo--during the return flight at 30, 60 and 90 minutes after take-off. TTE was also done after every dive during the week's diving. Divers were divided into three groups according to their 'bubble-proneness': non-bubblers, occasional bubblers and consistent bubblers. RESULTS: During the diving, 23 subjects never developed bubbles, 17 only occasionally and 16 subjects produced bubbles every day and after every dive. Bubbles on the return flight were observed in eight of the 56 divers (all from the 'bubblers' group). Two subjects who had the highest bubble scores during the diving were advised not to make the last dive (increasing their PFSI to approximately 36 hours), and did not demonstrate bubbles on the return flight. CONCLUSIONS: Even though a 24-hour PFSI is recommended on the basis of clinical trials showing a low risk of decompression sickness (DCS), the presence of venous gas bubbles in-flight in eight of 56 divers leads us to suspect that in real-life situations DCS risk after such a PFSI is not zero.
Authors: Denise F Blake; Melissa Crowe; Simon J Mitchell; Peter Aitken; Neal W Pollock Journal: Diving Hyperb Med Date: 2018-12-24 Impact factor: 0.887