Lehnigk B, Jörres R A, Elliott D H, Holthaus J, Magnussen H
Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, LVA Freie und Hansestadt Hamburg, Germany.
Int Arch Occup Environ Health. 1997;69(3):201-8. doi: 10.1007/s004200050137.
We studied the effects of an experimental saturation dive to 360 and 450 m in a simulation chamber on spirometric lung function, diffusing capacity, pulmonary compliance, and exercise performance in eight professional divers (age 22-40 years). To assess intraindividual variability, all parameters were measured on 2 days before and on 2 consecutive days immediately after the dive. For the group as a whole there was a significant increase in vital capacity and alveolar volume, and a decrease in Krogh factor and specific compliance (P < 0.01). These changes were reduced on the 2nd day after the dive. All subjects showed lowered exercise performance after the dive. Arterial pressure of oxygen and ventilation during exercise increased (P < 0.01), whereas arterial pressure of carbon dioxide, oxygen uptake, and anaerobic threshold decreased (P < 0.01). Exercise parameters showed only a slight trend towards pre-dive values on the 2nd day after a dive. The individual analysis revealed that after the dive two subjects showed a marked decrease in diffusing capacity and a more than average decrease in Krogh factor (TLCO/VA). One of them had signs of mild decompression sickness and the other, signs of pre-existing obstructive airways disease. Our data are compatible with the hypothesis that the effects of a single deep saturation dive on pulmonary function and exercise performance are the results of counteracting mechanisms. We suggest that lung volumes increase due to the enhanced work of breathing during a deep saturation dive and that these changes could mask an impairment in gas exchange. Furthermore, a saturation dive can induce an apparent deterioration of pulmonary function.
我们在模拟舱中对8名职业潜水员(年龄22 - 40岁)进行了360米和450米的实验性饱和潜水,研究其对肺功能、弥散能力、肺顺应性和运动表现的影响。为评估个体内变异性,在潜水前2天及潜水后连续2天测量所有参数。对于整个组而言,肺活量和肺泡容积显著增加,克罗格因子和比顺应性降低(P < 0.01)。这些变化在潜水后第2天有所减轻。所有受试者潜水后运动表现均下降。运动期间动脉血氧分压和通气增加(P < 0.01),而动脉血二氧化碳分压、摄氧量和无氧阈值降低(P < 0.01)。潜水后第2天,运动参数仅略微趋向于潜水前值。个体分析显示,潜水后两名受试者弥散能力显著下降,克罗格因子(TLCO/VA)下降幅度超过平均水平。其中一人有轻度减压病迹象,另一人有既往阻塞性气道疾病迹象。我们的数据与以下假设相符:单次深度饱和潜水对肺功能和运动表现的影响是相互抵消机制的结果。我们认为,深度饱和潜水期间呼吸功增强导致肺容积增加,这些变化可能掩盖气体交换受损。此外,饱和潜水可导致肺功能明显恶化。