Cialoni Danilo, Pieri Massimo, Balestra Costantino, Marroni Alessandro
DAN Europe Research Division, Contrada Padune 11, 64026 Roseto degli, Abruzzi (TE), Italy, Phone: +39(0)85-893-0333, Fax: +39-(0)85-893-0050, E-mail:
DAN Europe Research Division, Roseto degli Abruzzi, Italy.
Diving Hyperb Med. 2015 Mar;45(1):10-5.
Inert gas accumulated after multiple recreational dives can generate tissue supersaturation and bubble formation when ambient pressure decreases. We hypothesized that this could happen even if divers respected the currently recommended 24-hour pre-flight surface interval (PFSI).
We performed transthoracic echocardiography (TTE) on a group of 56 healthy scuba divers (39 male, 17 female) as follows: first echo--during the outgoing flight, no recent dives; second echo--before boarding the return flight, after a multiday diving week in the tropics and a 24-hour PFSI; third echo--during the return flight at 30, 60 and 90 minutes after take-off. TTE was also done after every dive during the week's diving. Divers were divided into three groups according to their 'bubble-proneness': non-bubblers, occasional bubblers and consistent bubblers.
During the diving, 23 subjects never developed bubbles, 17 only occasionally and 16 subjects produced bubbles every day and after every dive. Bubbles on the return flight were observed in eight of the 56 divers (all from the 'bubblers' group). Two subjects who had the highest bubble scores during the diving were advised not to make the last dive (increasing their PFSI to approximately 36 hours), and did not demonstrate bubbles on the return flight.
Even though a 24-hour PFSI is recommended on the basis of clinical trials showing a low risk of decompression sickness (DCS), the presence of venous gas bubbles in-flight in eight of 56 divers leads us to suspect that in real-life situations DCS risk after such a PFSI is not zero.
多次休闲潜水后积聚的惰性气体会在环境压力降低时导致组织过饱和并形成气泡。我们推测，即使潜水员遵守当前建议的飞行前24小时水面间隔时间（PFSI），这种情况仍可能发生。
我们对一组56名健康的水肺潜水员（39名男性，17名女性）进行了经胸超声心动图（TTE）检查，具体如下：第一次超声心动图检查——在出发航班期间，近期无潜水经历；第二次超声心动图检查——在登上返程航班前，经过在热带地区的一周多日潜水及24小时的PFSI之后；第三次超声心动图检查——在返程航班起飞后30、60和90分钟时进行。在一周的潜水过程中，每次潜水后也进行TTE检查。潜水员根据其“气泡易感性”分为三组：无气泡者、偶尔出现气泡者和持续出现气泡者。
在潜水过程中，23名受试者从未出现气泡，17名只是偶尔出现，16名受试者每天及每次潜水后都会产生气泡。56名潜水员中有8名（均来自“气泡产生者”组）在返程航班上被观察到有气泡。两名在潜水期间气泡评分最高的受试者被建议不要进行最后一次潜水（将其PFSI延长至约36小时），他们在返程航班上未出现气泡。
尽管基于显示减压病（DCS）风险较低的临床试验建议采用24小时的PFSI，但56名潜水员中有8名在飞行中出现静脉气泡，这使我们怀疑在现实生活中，经过这样的PFSI后DCS风险并非为零。
