Aerosp Med Hum Perform. 2021 Jan 1;92(1):39-42. doi: 10.3357/AMHP.5710.2021.
In their seminal work, McGuire and colleagues reported an increased incidence of white matter hyperintensities (WMH) in a cohort of U2 pilots and hypobaric chamber personnel. WMH burden was higher in U2 pilots with previous reports of decompression sickness (DCS), and McGuire's reports have raised concerns regarding adverse outcomes in the aftermath of hypobaric exposures. Accordingly, a NATO working group has recently revised its standard recommendations regarding hypobaric exposures, including measures to mitigate the risk of WMH. Mandatory recovery time for up to 72 h between repeated exposures has been suggested on the basis of experimental evidence. However, we argue that the evidence is scarce which supports restricting repeated exposures to mitigate WMH. It is plausible that WMH is correlated with DCS and emphasis should be made on limiting the duration of exposures rather than restricting short and repeated exposures. The profiles in the NATO recommendations are meant to mitigate the risk of DCS. Still, they will potentially expose NATO Air Force and Special Operations personnel to flight profiles that can give rise to DCS incidence above 35%. Awaiting reliable data, we recommend limiting the duration of exposures and allowing for short repeated exposures.
在他们的开创性工作中，McGuire 及其同事报告称，在 U2 飞行员和减压舱人员队列中，脑白质高信号（WMH）的发生率增加。在有减压病（DCS）既往报告的 U2 飞行员中，WMH 负担更高，McGuire 的报告引起了人们对减压暴露后不良后果的关注。因此，北约工作组最近修订了其关于减压暴露的标准建议，包括减轻 WMH 风险的措施。根据实验证据，建议在重复暴露之间强制恢复长达 72 小时。然而，我们认为，支持限制重复暴露以减轻 WMH 的证据很少。WMH 与 DCS 相关，因此应强调限制暴露时间，而不是限制短期和重复暴露。北约建议中的方案旨在降低 DCS 的风险。不过，它们可能会使北约空军和特种作战人员面临可能导致 DCS 发生率超过 35%的飞行方案。在等待可靠数据的同时，我们建议限制暴露时间并允许进行短期重复暴露。
