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Title	Pub Year	Author	SearchLink Sort descending
Venous bubble count declines during strenuous exercise after an open sea dive to 30 m	2006	Department of Physiology, University of Split School of Medicine, Croatia. zdujic@bsb.mefst.hr	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Aviation, Space, and Environmental Medicine Periodical, Abbrev. Aviat.Space Environ.Med. Pub Date Free Form Jun Volume 77 Issue 6 Start Page 592 Other Pages 596 Notes LR: 20061115; JID: 7501714; 0 (Gases); ppublish Place of Publication United States ISSN/ISBN 0095-6562; 0095-6562 Accession Number PMID: 16780236 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; IM; S DOI Output Language Unknown(0) PMID 16780236 Abstract INTRODUCTION: The effect of post-dive exercise on bubble formation remains controversial, although the current practice of divers and aviators is to avoid strenuous exercise after diving. Previously, we have shown that exercising 24 h before a dive, or during a decompression stop, significantly reduces bubble formation in man. The objective of this study was to determine whether a short period of strenuous post-dive exercise promotes venous bubble formation. METHODS: Seven male military divers performed an open-sea field dive to a maximum depth of 30 m for 30 min. At maximum depth, subjects performed mild underwater fin swimming, followed by standard decompression. Diving was followed by a post-dive exercise session consisting of short, strenuous incremental upright cycle ergometry, up to 85% of maximal oxygen uptake, for about 10 min. Subjects were monitored for venous gas bubbles in the right heart with an echo-imaging system starting 20 min post-dive while in the supine position, during cycle ergometry in the seated upright position, and immediately after exercise in a supine position. RESULTS: The average number of bubbles was 1.5 +/- 1.4 bubbles x cm(-2) 20 min after diving. Changes in posture from supine to seated upright resulted in significant reduction of bubbles to 0.6 +/- 1.3 bubbles x cm(-2) (p = 0.043), with further reduction to 0.2 +/- 0.3 bubbles x cm(-2) at the end of exercise (p = 0.02). No cases of DCS or intra-pulmonary shunt were observed during or following post-dive exercise. DISCUSSION: These results suggest that post-dive strenuous exercise after a single field dive reduces post-dive gas bubble formation in well-trained military divers. Additional findings are needed for normal sports divers. Descriptors Adult, Decompression Sickness/prevention & control, Diving/physiology, Exercise/physiology, Gases/blood, Humans, Male, Military Medicine, Statistics, Nonparametric, Veins Links Book Title Database Publisher Data Source Authors Dujic,Z., Obad,A., Palada,I., Ivancev,V., Valic,Z. Original/Translated Title URL Date of Electronic PMCID Editors
Exogenous nitric oxide and bubble formation in divers	2006	Departments of Physiology, University of Split School of Medicine, Split, Croatia. zdujic@bsb.mefst.hr	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Medicine and science in sports and exercise Periodical, Abbrev. Med.Sci.Sports Exerc. Pub Date Free Form Aug Volume 38 Issue 8 Start Page 1432 Other Pages 1435 Notes LR: 20131121; JID: 8005433; 0 (Gases); 0 (Nitric Oxide Donors); G59M7S0WS3 (Nitroglycerin); ppublish Place of Publication United States ISSN/ISBN 0195-9131; 0195-9131 Accession Number PMID: 16888456 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; IM; S DOI 10.1249/01.mss.0000228936.78916.23 [doi] Output Language Unknown(0) PMID 16888456 Abstract PURPOSE: Prevention of bubble formation is a central goal in standard decompression procedures. Previously we have shown that exercise 20-24 h prior to a dive reduces bubble formation and increases survival in rats exposed to a simulated dive. Furthermore, we have demonstrated that nitric oxide (NO) may be involved in this protection; blocking the production of NO increases bubble formation while giving rats a long-lasting NO donor 20 h and immediately prior to a dive reduces bubble formation. This study determined whether a short-lasting NO donor, nitroglycerine, reduced bubble formation after standard dives and decompression in man. METHODS: A total of 16 experienced divers were randomly assigned into two groups. One group performed two dives to 30 m of seawater (msw) for 30 min breathing air, and performed exercise at an intensity corresponding to 30% of maximal oxygen uptake during the bottom time. The second group performed two simulated dives to 18 msw for 80 min breathing air in a hyperbaric chamber, and remained sedentary during the bottom period. The first dive for each diver served as the control dive, whereas the divers received 0.4 mg of nitroglycerine by oral spray 30 min before the second dive. Following the dive, gas bubbles in the pulmonary artery were recorded using ultrasound. RESULTS: The open-water dive resulted in significantly more gas bubbles than the dry dive (0.87 +/- 1.3 vs 0.12 +/- 0.23 bubbles per square centimeter). Nitroglycerine reduced bubble formation significantly in both dives from 0.87 +/- 1.3 to 0.32 +/- 0.7 in the in-water dive and from 0.12 +/- 0.23 to 0.03 +/- 0.03 bubbles per square centimeter in the chamber dive. CONCLUSION: The present study demonstrates that intake of a short-lasting NO donor reduces bubble formation following decompression after different dives. Descriptors Adult, Decompression Sickness/physiopathology/prevention & control/ultrasonography, Diving/physiology, Gases/blood, Heart Rate/physiology, Humans, Hyperbaric Oxygenation, Male, Nitric Oxide Donors/administration & dosage, Nitroglycerin/administration & dosage, Oxygen Consumption/physiology, Pulmonary Artery/ultrasonography Links Book Title Database Publisher Data Source Authors Dujic,Z., Palada,I., Valic,Z., Duplancic,D., Obad,A., Wisloff,U., Brubakk,A. O. Original/Translated Title URL Date of Electronic PMCID Editors
Sonographic detection of intrapulmonary shunting of venous gas bubbles during exercise after diving in a professional diver	2007	Department of Physiology, University of Split School of Medicine, Split, Croatia.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Journal of clinical ultrasound : JCU Periodical, Abbrev. J.Clin.Ultrasound Pub Date Free Form Oct Volume 35 Issue 8 Start Page 473 Other Pages 476 Notes LR: 20101014; CI: (c) 2007; JID: 0401663; CIN: J Clin Ultrasound. 2010 Nov-Dec;38(9):497; author reply 498. PMID: 20853430; ppublish Place of Publication United States ISSN/ISBN 0091-2751; 0091-2751 Accession Number PMID: 17676615 Language eng SubFile Case Reports; Journal Article; IM DOI 10.1002/jcu.20378 [doi] Output Language Unknown(0) PMID 17676615 Abstract We report a case of right-to-left intrapulmonary (IP) shunting of venous gas bubbles at a high level of exercise after diving. The diagnosis was made using a 4-chamber view of the heart via echocardiography during exercise. This case is the first in which we could find evidence of IP shunt recruitment during exercise after diving, and the bubble grade was the highest ever seen in our laboratory. Venous bubbles crossing over through IP shunts during exercise after diving is a very rare event. Descriptors Adult, Decompression Sickness/etiology/ultrasonography, Diving/adverse effects, Echocardiography, Doppler/methods, Embolism, Air/etiology/physiopathology/ultrasonography, Humans, Lung/blood supply, Male, Pulmonary Veins/ultrasonography Links Book Title Database Publisher Wiley Periodicals, Inc Data Source Authors Obad,A., Palada,I., Ivancev,V., Valic,Z., Fabijanic,D., Brubakk,A. O., Dujic,Z. Original/Translated Title URL Date of Electronic PMCID Editors
Blood platelet count and bubble formation after a dive to 30 msw for 30 min	2008	Departement des facteurs humains, Centre de Recherches du Service de Sante des Armees, La Tronche, France. jm.pontier@free.fr	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Aviation, Space, and Environmental Medicine Periodical, Abbrev. Aviat.Space Environ.Med. Pub Date Free Form Dec Volume 79 Issue 12 Start Page 1096 Other Pages 1099 Notes JID: 7501714; ppublish Place of Publication United States ISSN/ISBN 0095-6562; 0095-6562 Accession Number PMID: 19070304 Language eng SubFile Journal Article; IM; S DOI Output Language Unknown(0) PMID 19070304 Abstract INTRODUCTION: Previous human studies reported that platelet count (PC) is decreased following decompression. Platelet aggregation and adherence to the bubble surface has been demonstrated in severe decompression sickness (DCS). The present study was designed to clarify the relationship between post-dive changes in blood PC and the level of bubble formation in divers. METHODS: There were 40 healthy experienced divers who were assigned to 1 experimental group (N = 30) with an open-sea air dive to 30 msw for 30 min in field conditions and 1 control group (N = 10) without hyperbaric exposure. Bubble grades were monitored with a pulsed Doppler according to the Spencer scale and Kissman integrated severity score (KISS). Blood samples for red blood cell counts (RBC), hematocrit (Hct), and PC were taken 1 h before and after exposure in two groups. RESULTS: None of the divers developed any signs of DCS. In two groups, the results showed significant increase in RBC count and Hct related with hemoconcentration and no change in PC. Divers with a high KISS score (39 +/- 5.8; mean +/- SD) presented a significantly more pronounced percent fall in PC than divers with a lower KISS score. We found a significant correlation between the percent fall in PC after a dive and the bubble KISS score. DISCUSSION: The present study highlighted a relationship between the post-dive decrease in PC and the magnitude of bubble level after decompression. Our primary result is that the post-dive decrease in PC could be a predictor of decompression severity after diving. Descriptors Adult, Decompression/adverse effects, Decompression Sickness/blood/etiology, Diving/adverse effects, Embolism, Air/blood/etiology, Health Status Indicators, Humans, Male, Platelet Aggregation, Platelet Count, Pressure, Prospective Studies, Time Factors Links Book Title Database Publisher Data Source Authors Pontier,J. M., Jimenez,C., Blatteau,J. E. Original/Translated Title URL Date of Electronic PMCID Editors
Effect of in-water recompression with oxygen to 6 msw versus normobaric oxygen breathing on bubble formation in divers	2009	Ecole de Plongee Marine Nationale, 83800 Toulon Armees, France. je.blatteau@infonie.fr	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full European journal of applied physiology Periodical, Abbrev. Eur.J.Appl.Physiol. Pub Date Free Form Jul Volume 106 Issue 5 Start Page 691 Other Pages 695 Notes LR: 20131121; JID: 100954790; 059QF0KO0R (Water); S88TT14065 (Oxygen); 2009/04/15 [accepted]; 2009/05/08 [aheadofprint]; ppublish Place of Publication Germany ISSN/ISBN 1439-6327; 1439-6319 Accession Number PMID: 19424716 Language eng SubFile Journal Article; Randomized Controlled Trial; IM DOI 10.1007/s00421-009-1065-y [doi] Output Language Unknown(0) PMID 19424716 Abstract It is generally accepted that the incidence of decompression sickness (DCS) from hyperbaric exposures is low when few or no bubbles are present in the circulation. To date, no data are available on the influence of in-water oxygen breathing on bubble formation following a provocative dive in man. The purpose of this study was to compare the effect of post-dive hyperbaric versus normobaric oxygen breathing (NOB) on venous circulating bubbles. Nineteen divers carried out open-sea field air dives at 30 msw depth for 30 min followed by a 9 min stop at 3 msw. Each diver performed three dives: one control dive, and two dives followed by 30 min of hyperbaric oxygen breathing (HOB) or NOB; both HOB and NOB started 10 min after surfacing. For HOB, divers were recompressed in-water to 6 msw at rest, whereas NOB was performed in a dry room in supine position. Decompression bubbles were examined by a precordial pulsed Doppler. Bubble count was significantly lower for post-dive NOB than for control dives. HOB dramatically suppressed circulating bubble formation with a bubble count significantly lower than for NOB or controls. In-water recompression with oxygen to 6 msw is more effective in removing gas bubbles than NOB. This treatment could be used in situations of "interrupted" or "omitted" decompression, where a diver returns to the water in order to complete decompression prior to the onset of symptoms. Further investigations are needed before to recommend this protocol as an emergency treatment for DCS. Descriptors Adult, Decompression/adverse effects, Decompression Sickness/physiopathology/prevention & control, Diving/physiology, Embolism, Air/prevention & control, Humans, Hyperbaric Oxygenation/methods, Immersion, Male, Middle Aged, Osmolar Concentration, Oxygen/pharmacology/therapeutic use, Oxygen Consumption/physiology, Respiration, Water, Young Adult Links Book Title Database Publisher Data Source Authors Blatteau,J. E., Pontier,J. M. Original/Translated Title URL Date of Electronic 20090508 PMCID Editors
Effect of in-water oxygen prebreathing at different depths on decompression-induced bubble formation and platelet activation	2010	Department of Basic and Applied Medical Sciences, Ud'A Chieti-Pescara, Italy.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Journal of applied physiology (Bethesda, Md.: 1985) Periodical, Abbrev. J.Appl.Physiol.(1985) Pub Date Free Form May Volume 108 Issue 5 Start Page 1077 Other Pages 1083 Notes LR: 20131121; JID: 8502536; 0 (ITGB3 protein, human); 0 (Integrin beta3); 0 (P-Selectin); 0 (Platelet Membrane Glycoprotein IIb); S88TT14065 (Oxygen); 2010/02/25 [aheadofprint]; ppublish Place of Publication United States ISSN/ISBN 1522-1601; 0161-7567 Accession Number PMID: 20185629 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; IM DOI 10.1152/japplphysiol.01058.2009 [doi] Output Language Unknown(0) PMID 20185629 Abstract Effect of in-water oxygen prebreathing at different depths on decompression-induced bubble formation and platelet activation in scuba divers was evaluated. Six volunteers participated in four diving protocols, with 2 wk of recovery between dives. On dive 1, before diving, all divers breathed normally for 20 min at the surface of the sea (Air). On dive 2, before diving, all divers breathed 100% oxygen for 20 min at the surface of the sea [normobaric oxygenation (NBO)]. On dive 3, before diving, all divers breathed 100% O2 for 20 min at 6 m of seawater [msw; hyperbaric oxygenation (HBO) 1.6 atmospheres absolute (ATA)]. On dive 4, before diving, all divers breathed 100% O2 for 20 min at 12 msw (HBO 2.2 ATA). Then they dove to 30 msw (4 ATA) for 20 min breathing air from scuba. After each dive, blood samples were collected as soon as the divers surfaced. Bubbles were measured at 20 and 50 min after decompression and converted to bubble count estimate (BCE) and numeric bubble grade (NBG). BCE and NBG were significantly lower in NBO than in Air [0.142+/-0.034 vs. 0.191+/-0.066 (P<0.05) and 1.61+/-0.25 vs. 1.89+/-0.31 (P<0.05), respectively] at 20 min, but not at 50 min. HBO at 1.6 ATA and 2.2 ATA has a similar significant effect of reducing BCE and NBG. BCE was 0.067+/-0.026 and 0.040+/-0.018 at 20 min and 0.030+/-0.022 and 0.020+/-0.020 at 50 min. NBG was 1.11+/-0.17 and 0.92+/-0.16 at 20 min and 0.83+/-0.18 and 0.75+/-0.16 at 50 min. Prebreathing NBO and HBO significantly alleviated decompression-induced platelet activation. Activation of CD62p was 3.0+/-0.4, 13.5+/-1.3, 10.7+/-0.9, 4.5+/-0.7, and 7.6+/-0.8% for baseline, Air, NBO, HBO at 1.6 ATA, and HBO at 2.2 ATA, respectively. The data show that prebreathing oxygen, more effective with HBO than NBO, decreases air bubbles and platelet activation and, therefore, may be beneficial in reducing the development of decompression sickness. Descriptors Administration, Inhalation, Adult, Decompression/adverse effects, Decompression Sickness/blood/physiopathology/prevention & control/ultrasonography, Diving, Embolism, Air/blood/physiopathology/prevention & control/ultrasonography, Humans, Hyperbaric Oxygenation, Immersion, Inhalation, Integrin beta3/blood, Male, Middle Aged, Oxygen/administration & dosage, P-Selectin/blood, Platelet Activation, Platelet Membrane Glycoprotein IIb/blood, Time Factors, Ultrasonography, Doppler, Young Adult Links Book Title Database Publisher Data Source Authors Bosco,G., Yang,Z. J., Di Tano,G., Camporesi,E. M., Faralli,F., Savini,F., Landolfi,A., Doria,C., Fano,G. Original/Translated Title URL Date of Electronic 20100225 PMCID Editors
Venous and arterial bubbles at rest after no-decompression air dives	2011	Department of Physiology, University of Split School of Medicine, Split, Croatia.	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Medicine and science in sports and exercise Periodical, Abbrev. Med.Sci.Sports Exerc. Pub Date Free Form Jun Volume 43 Issue 6 Start Page 990 Other Pages 995 Notes JID: 8005433; ppublish Place of Publication United States ISSN/ISBN 1530-0315; 0195-9131 Accession Number PMID: 21085032 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; IM; S DOI 10.1249/MSS.0b013e31820618d3 [doi] Output Language Unknown(0) PMID 21085032 Abstract PURPOSE: During SCUBA diving, breathing at increased pressure leads to a greater tissue gas uptake. During ascent, tissues may become supersaturated, and the gas is released in the form of bubbles that typically occur on the venous side of circulation. These venous gas emboli (VGE) are usually eliminated as they pass through the lungs, although their occasional presence in systemic circulation (arterialization) has been reported and it was assumed to be the main cause of the decompression sickness. The aims of the present study were to assess the appearance of VGE after air dives where no stops in coming to the surface are required and to assess their potential occurrence and frequency in the systemic circulation. METHODS: Twelve male divers performed six dives with 3 d of rest between them following standard no-decompression dive procedures: 18/60, 18/70, 24/30, 24/40, 33/15, and 33/20 (the first value indicates depth in meters of sea water and the second value indicates bottom time in minutes). VGE monitoring was performed ultrasonographically every 20 min for 120 min after surfacing. RESULTS: Diving profiles used in this study produced unexpectedly high amounts of gas bubbles, with most dives resulting in grade 4 (55/69 dives) on the bubble scale of 0-5 (no to maximal bubbles). Arterializations of gas bubbles were found in 5 (41.7%) of 12 divers and after 11 (16%) of 69 dives. These VGE crossovers were only observed when a large amount of bubbles was concomitantly present in the right valve of the heart. CONCLUSIONS: Our findings indicate high amounts of gas bubbles produced after no-decompression air dives based on standardized diving protocols. High bubble loads were frequently associated with the crossover of VGE to the systemic circulation. Despite these findings, no acute decompression-related pathology was detected. Descriptors Links Book Title Database Publisher Data Source Authors Ljubkovic,M., Dujic,Z., Mollerlokken,A., Bakovic,D., Obad,A., Breskovic,T., Brubakk,A.O. Original/Translated Title URL Date of Electronic PMCID Editors
Doppler bubble grades after diving and relevance of body fat	2012	Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, The Netherlands. n.a.schellart@amc.uva.nl	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Aviation, Space, and Environmental Medicine Periodical, Abbrev. Aviat.Space Environ.Med. Pub Date Free Form Oct Volume 83 Issue 10 Start Page 951 Other Pages 957 Notes LR: 20140131; JID: 7501714; CIN: Aviat Space Environ Med. 2014 Jan;85(1):84-5. PMID: 24479268; CIN: Aviat Space Environ Med. 2014 Jan;85(1):84. PMID: 24479267; ppublish Place of Publication United States ISSN/ISBN 0095-6562; 0095-6562 Accession Number PMID: 23066616 Language eng SubFile Journal Article; IM; S DOI Output Language Unknown(0) PMID 23066616 Abstract BACKGROUND: From the literature on venous gas embolism (VGE) and decompression sickness (DCS), it remains unclear whether body fat is a predisposing factor for VGE and DCS. Therefore, this study analyses body fat (range 16-44%) in relation to precordial VGE measured by Doppler bubble grades. Also examined is the effect of age (range 34-68 yr), body mass index (BMI; range 17-34 kg x m(-2)), and a model estimate of VO2(max) (maximal oxygen uptake; range 24-54 ml x kg(-1) x min(-1)). METHODS: Bubble grades were determined in 43 recreational divers after an open sea air dive of 40 min to 20 m. Doppler bubble grade scores were transformed to the logarithm of the number of bubbles/cm2, logB, and the logarithm of the Kissman Integrated Severity Score (KISS) to allow numerical analysis. Statistical analyses were performed with Pearson's regular and partial correlations, and uni- and multivariate linear regressions. RESULTS: For divers in their midlife (and older), the analyses indicate that neither body fat nor BMI stimulate bubble formation, since correlations were nonsignificant. In contrast, age and especially VO2(max) appeared to determine VGE. For these types of dives it was found that logB = -1.1 + 0.02 age - 0.04Vo2(max). CONCLUSION: Based on these data we conclude that body fat and BMI seem less relevant for diving. We recommend that medical examinations pay more attention to VO2(max) and age, and that international dive institutions come to a consensus regarding VO2(max) criteria. Descriptors Links Book Title Database Publisher Data Source Authors Schellart,N.A., Vellinga,T.P., van Dijk,F.J., Sterk,W. Original/Translated Title URL Date of Electronic PMCID Editors
Patent foramen ovale and the risk of paradoxical embolization of venous bubbles in divers - cave for foam sclerotization of varicose veins	2012	Kardiologicka klinika. jakub.honek@gmail.com	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti Periodical, Abbrev. Rozhl.Chir. Pub Date Free Form Jul Volume 91 Issue 7 Start Page 378 Other Pages 380 Notes JID: 9815441; ppublish Place of Publication Czech Republic ISSN/ISBN 0035-9351; 0035-9351 Accession Number PMID: 23078256 Language cze SubFile English Abstract; Journal Article; IM DOI 38891 [pii] Output Language Unknown(0) PMID 23078256 Abstract INTRODUCTION: Foam sclerotization of varicose veins may cause paradoxical embolization through patent foramen ovale (PFO). The aim of our study was to: 1) select an optimal screening method for the detection of PFO; 2) determine the prevalence of PFO in a non-selected population; and 3) test the risk of paradoxical embolization of venous bubbles in patients with PFO. MATERIALS AND METHODS: A diver after decompression is a suitable model for determining the risk of paradoxical embolization of venous gas bubbles. 329 Czech divers were screened for PFO. In a pilot study, we compared Transcranial Doppler Sonography (TCD) with Transesophageal Echocardiography (TEE) in 100 patients. TCD alone was used for further screening. In 31 divers with PFO, nitrogen bubbles were detected after simulated dives. Transthoracic Echocardiography (TTE) was used to detect venous bubbles in right-sided heart chambers; TTE and TCD were used to detect arterial bubbles. The right-to-left shunt was rated as non-significant ( Descriptors Links Book Title Database Publisher Data Source Authors Honek,J., Honek,T., Januska,J., Sebesta,P., Novotny,S., Sefc,L., Fiedler,J., Sramek,M., Horvath,M., Parobkova,M. Original/Translated Title Perzistence foramen ovale patens a riziko paradoxni embolizace zilnich bublin u potapecu - cave pro sklerotizaci varixu penovou metodou URL Date of Electronic PMCID Editors
Ultrasound detection of vascular decompression bubbles: the influence of new technology and considerations on bubble load	2014	SLB Consulting, C/O The Barn, Manor House Wynd, Winton, Cumbria, CA17 4HL, UK, Phone: +44-(0)771-442-2042, E-mail: lesley@chapelclose20.fsnet.co.uk.; Department of Environmental Physiology, School of Technology and Health, Royal Institute of Technology, S	Read more...
Source Type Print(0) Ref Type Journal Article Periodical, Full Diving and hyperbaric medicine Periodical, Abbrev. Diving.Hyperb.Med. Pub Date Free Form Mar Volume 44 Issue 1 Start Page 35 Other Pages 44 Notes LR: 20141212; JID: 101282742; OTO: NOTNLM; 2013/08/02 [received]; 2014/01/26 [accepted]; ppublish Place of Publication Australia ISSN/ISBN 1833-3516; 1833-3516 Accession Number PMID: 24687484 Language eng SubFile Journal Article; Research Support, Non-U.S. Gov't; Review; IM DOI Output Language Unknown(0) PMID 24687484 Abstract INTRODUCTION: Diving often causes the formation of 'silent' bubbles upon decompression. If the bubble load is high, then the risk of decompression sickness (DCS) and the number of bubbles that could cross to the arterial circulation via a pulmonary shunt or patent foramen ovale increase. Bubbles can be monitored aurally, with Doppler ultrasound, or visually, with two dimensional (2D) ultrasound imaging. Doppler grades and imaging grades can be compared with good agreement. Early 2D imaging units did not provide such comprehensive observations as Doppler, but advances in technology have allowed development of improved, portable, relatively inexpensive units. Most now employ harmonic technology; it was suggested that this could allow previously undetectable bubbles to be observed. METHODS: This paper provides a review of current methods of bubble measurement and how new technology may be changing our perceptions of the potential relationship of these measurements to decompression illness. Secondly, 69 paired ultrasound images were made using conventional 2D ultrasound imaging and harmonic imaging. Images were graded on the Eftedal-Brubakk (EB) scale and the percentage agreement of the images calculated. The distribution of mismatched grades was analysed. RESULTS: Fifty-four of the 69 paired images had matching grades. There was no significant difference in the distribution of high or low EB grades for the mismatched pairs. CONCLUSIONS: Given the good level of agreement between pairs observed, it seems unlikely that harmonic technology is responsible for any perceived increase in observed bubble loads, but it is probable that our increasing use of 2D ultrasound to assess dive profiles is changing our perception of 'normal' venous and arterial bubble loads. Methods to accurately investigate the load and size of bubbles developed will be helpful in the future in determining DCS risk. Descriptors Links Book Title Database Publisher Data Source Authors Blogg,S.L., Gennser,M., Mollerlokken,A., Brubakk,A.O. Original/Translated Title URL Date of Electronic PMCID Editors

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