Eynan Mirit, Tal Dror, Arie Efrat, Ne'eman Frida, Adir Yochai
Israel Naval Medical Institute, Medical Corps, Haifa, Israel.
Aviat Space Environ Med. 2006 Oct;77(10):1028-33.
Elevated arterial PCO2 (hypercapnia) increases the risk of CNS oxygen toxicity when diving with enriched oxygen gas mixtures. A CO2 detection and retention test is conducted as a matter of routine at the Israel Naval Medical Institute for physiological training, and as a screening tool for divers who may be prone to suffer from CNS oxygen toxicity. This test does not include an "attention distracter", which would provide a better simulation of the true situation during actual diving. The purpose of the present study was to examine the hypothesis that the addition of cognitive tasks to the CO2 detection and retention test might alter divers' detection ability.
We assessed ventilatory and perceptual responses to variations in inspired CO2 (range 0-5.6 kPa, 0-42 mmHg) during moderate exercise, with and without the addition of cognitive tasks, in 15 Israel Navy combat divers on active duty. The first stage was the CO2 detection training session, followed by the CO2 detection test session (TEST) and the CO2 detection test session while doing cognitive tasks (COGN). The latter two sessions were performed by some of the subjects in reverse order.
We found that the mean (+/- SD) PICO2 at the detection threshold was significantly lower in the COGN (1.7 +/- 0.8 kPa, 12.7 +/- 6.0 mmHg) than in the TEST (2.4 +/- 0.6 kPa, 18.1 +/- 4.5 mmHg). The mean PETCO2 while inspiring 5.6 kPa (42 mmHg) CO2 was not significantly different in the two tests.
We suggest that the ability to detect CO2 during a dive is not impaired, but rather improves when the diver's attention is focused on other tasks.
使用富氧气体混合物潜水时,动脉血二氧化碳分压升高(高碳酸血症)会增加中枢神经系统氧中毒的风险。在以色列海军医学研究所,二氧化碳检测与潴留测试是生理训练的常规项目,也是可能易患中枢神经系统氧中毒的潜水员的筛查工具。该测试不包括“注意力干扰因素”,而这会更逼真地模拟实际潜水时的真实情况。本研究的目的是检验这样一个假设,即在二氧化碳检测与潴留测试中增加认知任务可能会改变潜水员的检测能力。
我们评估了15名现役以色列海军战斗潜水员在适度运动期间,在有和没有添加认知任务的情况下,对吸入二氧化碳变化(范围0 - 5.6 kPa,0 - 42 mmHg)的通气和感知反应。第一阶段是二氧化碳检测训练环节,随后是二氧化碳检测测试环节(TEST)以及在进行认知任务时的二氧化碳检测测试环节(COGN)。后两个环节由部分受试者以相反顺序进行。
我们发现,在检测阈值时,COGN组的平均(±标准差)呼气末二氧化碳分压(PICO2)(1.7±0.8 kPa,12.7±6.0 mmHg)显著低于TEST组(2.4±0.6 kPa,18.1±4.5 mmHg)。在吸入5.6 kPa(42 mmHg)二氧化碳时,两个测试中的平均呼气末二氧化碳分压(PETCO2)没有显著差异。
我们认为,潜水时检测二氧化碳的能力不会受损,相反,当潜水员的注意力集中在其他任务上时,检测能力会提高。