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潜水前次最大运动引起的血流动力学变化及其对气泡形成的影响。

Haemodynamic changes induced by submaximal exercise before a dive and its consequences on bubble formation.

作者信息

Blatteau Jean-Eric, Boussuges Alain, Gempp Emmanuel, Pontier Jean-Michel, Castagna Olivier, Robinet Claude, Galland Francois-Michel, Bourdon Lionel

机构信息

Département de Médecine Hyperbare, Hôpital d'Instruction des Armées Sainte-Anne, 83800 Toulon Armées, France.

出版信息

Br J Sports Med. 2007 Jun;41(6):375-9. doi: 10.1136/bjsm.2006.032359. Epub 2006 Nov 30.

Abstract

OBJECTIVES

To evaluate the effects of a submaximal exercise performed 2 h before a simulated dive on bubble formation and to observe the haemodynamic changes and their influence on bubble formation.

PARTICIPANTS AND METHODS

16 trained divers were compressed in a hyperbaric chamber to 400 kPa for 30 min and decompressed at a rate of 100 kPa/min with a 9 min stop at 130 kPa (French Navy MN90 procedure). Each diver performed two dives 3 days apart, one without exercise and one with exercise before the dive. All participants performed a 40 min constant-load submaximal and calibrated exercise, which consisted of outdoor running 2 h before the dive. Circulating bubbles were detected with a precordial Doppler at 30, 60 and 90 min after surfacing. Haemodynamic changes were evaluated with Doppler echocardiography.

RESULTS

A single bout of strenuous exercise 2 h before a simulated dive significantly reduced circulating bubbles. Post-exercise hypotension (PEH) was observed after exercise with reductions in diastolic and mean blood pressure (DBP and MBP), but total peripheral resistance was unchanged. Stroke volume was reduced, whereas cardiac output was unchanged. Simulated diving caused a similar reduction in cardiac output independent of pre-dive exercise, suggesting that pre-dive exercise only changed DBP and MBP caused by reduced stroke volume.

CONCLUSION

A single bout of strenuous exercise 2 h before a dive significantly reduced the number of bubbles in the right heart of divers and protected them from decompression sickness. Declining stroke volume and moderate dehydration induced by a pre-dive exercise might influence inert gas load and bubble formation.

摘要

目的

评估在模拟潜水前2小时进行次最大强度运动对气泡形成的影响,并观察血流动力学变化及其对气泡形成的影响。

参与者与方法

16名训练有素的潜水员在高压舱中被加压至400 kPa持续30分钟,然后以100 kPa/分钟的速率减压,在130 kPa处停留9分钟(法国海军MN90程序)。每位潜水员在相隔3天的时间内进行两次潜水,一次潜水前不运动,另一次潜水前运动。所有参与者进行40分钟的恒定负荷次最大强度且经过校准的运动,该运动包括在潜水前2小时进行户外跑步。在浮出水面后30、60和90分钟,用胸前多普勒检测循环气泡。用多普勒超声心动图评估血流动力学变化。

结果

在模拟潜水前2小时进行一次剧烈运动可显著减少循环气泡。运动后观察到运动后低血压(PEH),舒张压和平均血压(DBP和MBP)降低,但总外周阻力不变。每搏输出量降低,而心输出量不变。模拟潜水导致心输出量有类似程度的降低,与潜水前运动无关,这表明潜水前运动仅改变了因每搏输出量减少引起的DBP和MBP。

结论

潜水前2小时进行一次剧烈运动可显著减少潜水员右心的气泡数量,并保护他们免受减压病的影响。潜水前运动引起的每搏输出量下降和中度脱水可能会影响惰性气体负荷和气泡形成。

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