Mitchell Simon J, Doolette David J
Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.
Diving Hyperb Med. 2013 Jun;43(2):86-93.
Technical divers use gases other than air and advanced equipment configurations to conduct dives that are deeper and/or longer than typical recreational air dives. The use of oxygen-nitrogen (nitrox) mixes with oxygen fractions higher than air results in longer no-decompression limits for shallow diving, and faster decompression from deeper dives. For depths beyond the air-diving range, technical divers mix helium, a light non-narcotic gas, with nitrogen and oxygen to produce 'trimix'. These blends are tailored to the depth of intended use with a fraction of oxygen calculated to produce an inspired oxygen partial pressure unlikely to cause cerebral oxygen toxicity and a nitrogen fraction calculated to produce a tolerable degree of nitrogen narcosis. A typical deep technical dive will involve the use of trimix at the target depth with changes to gases containing more oxygen and less inert gas during the decompression. Open-circuit scuba may be used to carry and utilise such gases, but this is very wasteful of expensive helium. There is increasing use of closed-circuit 'rebreather' devices. These recycle expired gas and potentially limit gas consumption to a small amount of inert gas to maintain the volume of the breathing circuit during descent and the amount of oxygen metabolised by the diver. This paper reviews the basic approach to planning and execution of dives using these methods to better inform physicians of the physical demands and risks.
技术潜水员使用空气以外的气体和先进的设备配置进行潜水,这些潜水比典型的休闲空气潜水更深和/或更长。使用氧气含量高于空气的氧氮(氮氧混合气)混合气,可延长浅水区潜水的免减压极限,并加快深水区潜水后的减压速度。对于超出空气潜水范围的深度,技术潜水员将氦气(一种轻质非麻醉性气体)与氮气和氧气混合,制成“三混气”。这些混合气是根据预期使用深度定制的,其中氧气比例的计算目的是使吸入的氧分压不会导致脑氧中毒,氮气比例的计算目的是产生可耐受程度的氮麻醉。典型的深度技术潜水将在目标深度使用三混气,并在减压过程中更换为含氧量更高、惰性气体更少的气体。开路水肺潜水装置可用于携带和使用此类气体,但这会非常浪费昂贵的氦气。闭路“呼吸器”装置的使用越来越多。这些装置可循环呼出的气体,并有可能将气体消耗限制在少量惰性气体,以在潜水下降过程中维持呼吸回路的容积,并补充潜水员代谢的氧气量。本文回顾了使用这些方法进行潜水计划和执行的基本方法,以便让医生更好地了解其身体需求和风险。