Endocrine and Metabolic Surgery, Catholic University of the Sacred Heart, Rome, Italy.
Int J Sports Med. 2013 Oct;34(10):856-60. doi: 10.1055/s-0033-1334912. Epub 2013 May 13.
Erythropoiesis is affected during deep saturation dives. The mechanism should be related to a downregulation of serum Erythropoietin (s-EPO) concentration or to a toxic effect of the hyperbaric hyperoxia. We evaluated s-EPO and other haematological parameters in 6 scuba divers before, during and after a 14-days guinness saturation dive (8-10 m). Athletes were breathing air at 1.8-2 ATA, under the control of a team of physicians. Serum parameters were measured before diving (T0) and: 7 days (T1), 14 days (T2) after the beginning of the dive and 2 h (T3) and 24 h (T4) after resurfacing. Hgb, and many other haematological parameters did not change whereas Ht, s-EPO, the ratio between s-EPO predicted and that observed and reticulocytes (absolute, percent) declined progressively from T0 to T3. At T4 a significant rise in s-EPO was observed. Hgb did not vary but erythropoiesis seemed to be affected as s-EPO and reticulocyte counts showed. All these changes were statistically significant. The experiment, conducted in realistic conditions of dive length, oxygen concentration and pressure, allows us to formulate some hypotheses about the role of prolonged hyperbarism on erythropoiesis. The s-EPO rise, 24 h after resurfacing, is clearly documented and related to the "Normobaric Oxygen Paradox". This evidence suggests interesting hypotheses for new clinical applications such as modulation of s-EPO production and Hgb content triggered by appropriate O₂ administration in pre-surgical patients or in some anemic disease.
在深度饱和潜水期间，红细胞生成受到影响。其机制可能与血清促红细胞生成素 (s-EPO) 浓度下调有关，或者与高压高氧的毒性作用有关。我们评估了 6 名水肺潜水员在 14 天吉尼斯饱和潜水（8-10 m）前、中、后 s-EPO 和其他血液学参数。运动员在 1.8-2 ATA 下呼吸空气，由一组医生控制。在潜水前（T0）测量血清参数，并在潜水开始后 7 天（T1）、14 天（T2）以及浮出水面后 2 小时（T3）和 24 小时（T4）测量：Hgb 和许多其他血液学参数没有变化，而 Ht、s-EPO、s-EPO 预测值与观察值之比以及网织红细胞（绝对值、百分比）从 T0 到 T3 逐渐下降。在 T4 时观察到 s-EPO 显著升高。Hgb 没有变化，但正如 s-EPO 和网织红细胞计数所示，红细胞生成似乎受到影响。所有这些变化均具有统计学意义。该实验在潜水时间、氧气浓度和压力的实际条件下进行，使我们能够对长期高压对红细胞生成的作用提出一些假设。浮出水面后 24 小时 s-EPO 的升高得到了明确记录，并与“常压氧悖论”有关。这一证据为新的临床应用提出了有趣的假设，例如通过适当的 O₂ 给药调节 s-EPO 产生和 Hgb 含量，这在术前患者或某些贫血疾病中可能具有应用价值。
