Venous gas embolism after an open-water air dive and identical repetitive dive

• Published in: Undersea & hyperbaric medicine Vol. 39; no. 1; pp. 577 - 587
• Main Authors: Schellart, N A M, Sterk, W
• Format: Journal Article
• Language: English
• Published: United States Undersea & Hyperbaric Medical Society 01.01.2012
• Subjects: Age Factors; Algorithms; Decompression - methods; Decompression - standards; Decompression Sickness - etiology; Decompression Sickness - prevention & control; Diving; Diving - adverse effects; Diving - physiology; Diving - standards; Embolism, Air - blood; Embolism, Air - diagnostic imaging; Embolism, Air - etiology; Embolism, Air - prevention & control; Female; Humans; Male; Middle Aged; Models, Biological; Nitrogen; Nitrogen - blood; Physical fitness; Reference Values; Risk Assessment - methods; Scuba & skin diving; Space life sciences; Studies; Time Factors; Ultrasonography; Veins
• ISSN: 1066-2936

Decompression tables indicate that a repetitive dive to the same depth as a first dive should be shortened to obtain the same probability of occurrence of decompression sickness (pDCS). Repetition protocols are based on small numbers, a reason for re-examination. Since venous gas embolism (VGE) and pDCS are related, one would expect a higher bubble grade (BG) of VGE after the repetitive dive without reducing bottom time. BGs were determined in 28 divers after a first and an identical repetitive air dive of 40 minutes to 20 meters of sea water. Doppler BG scores were transformed to log number of bubbles/cm2 (logB) to allow numerical analysis. With a previously published model (Model2), pDCS was calculated for the first dive and for both dives together. From pDCS, theoretical logBs were estimated with a pDCS-to-logB model constructed from literature data. However, pDCS the second dive was provided using conditional probability. This was achieved in Model2 and indirectly via tissue saturations. The combination of both models shows a significant increase of logB after the second dive, whereas the measurements showed an unexpected lower logB. These differences between measurements and model expectations are significant (p-values < 0.01). A reason for this discrepancy is uncertain. The most likely speculation would be that the divers, who were relatively old, did not perform physical activity for some days before the first dive. Our data suggest that, wisely, the first dive after a period of no exercise should be performed conservatively, particularly for older divers.