Di Pumpo Fabio, Ruffino Giovanni, Malacarne Paolo
Italian Navy Medical Service Naval Academy, Livorno, Italy.
Italian Navy Medical Service COMSUBIN Varignano, Le Grazie, La Spezia, Italy.
Undersea Hyperb Med. 2019 Jan-Feb;46(1):1-6.
Hypoxia is one of the main problems an underwater diver may have to face. The probability of experiencing hypoxia is related to the type of dive and the equipment used. Hypoxia in diving is a potentially fatal event for the diver, as it can lead to the loss of brain functions and consequently to the loss of breathing control, all in the absence of specific premonitory symptoms. It is a risk that may be encountered more frequently by divers who use a closed-circuit rebreather (CCR). For those who use this type of equipment, hypoxia is usually the most frequent cause of death [1]. Our study was aimed at the detection of peripheral oxygen saturation in order to identify, in the future, a preclinical hypoxic condition. We combined the use of pulse oximetry with two forehead sensors on an underwater diver subject who was using an electronic closed-circuit rebreather (ECCR). Despite the known limits of this method and the preliminary status of these findings [2], the recorded data show a clear validity in the use of pulse oximetry in immersion for the detection of peripheral oxygen saturation. In the future, the pulse oximeter could become part of the instrumentation of the diver who uses CCR gear. The device could easily be implemented in these rebreathers. The possibility of being able to perform a basic instrumental analysis means that the diver can become more quickly aware of imminent hypoxia, characterized by the absence of clearly identifiable warning symptoms, and can put in place all the correct procedures for an emergency ascent, avoiding serious consequences.
缺氧是水下潜水员可能不得不面对的主要问题之一。发生缺氧的概率与潜水类型和使用的设备有关。潜水时的缺氧对潜水员来说是一个潜在的致命事件,因为它会导致脑功能丧失,进而导致呼吸控制丧失,而这一切都没有特定的先兆症状。使用闭路再循环呼吸器(CCR)的潜水员可能更频繁地遇到这种风险。对于使用这种设备的人来说,缺氧通常是最常见的死亡原因[1]。我们的研究旨在检测外周血氧饱和度,以便在未来识别临床前缺氧状态。我们将脉搏血氧测定法与两个前额传感器结合使用,应用于一名使用电子闭路再循环呼吸器(ECCR)的水下潜水员。尽管这种方法存在已知的局限性且这些发现尚处于初步阶段[2],但记录的数据表明,脉搏血氧测定法在浸入水中检测外周血氧饱和度方面具有明显的有效性。未来,脉搏血氧仪可能会成为使用CCR设备的潜水员装备的一部分。该设备可以很容易地在这些再循环呼吸器中实现。能够进行基本的仪器分析意味着潜水员可以更快地意识到即将发生的缺氧,这种缺氧没有明显可识别的警告症状,并且可以实施所有正确的紧急上升程序,避免严重后果。