Influence of oxygen enriched gases during decompression on bubble formation and endothelial function in self-contained underwater breathing apparatus diving: a randomized controlled study

Croat Med J. 2019 Jun 13;60(3):265-272. doi: 10.3325/cmj.2019.60.265.

Abstract

Aim: To assess the effect of air, gas mixture composed of 50% nitrogen and 50% oxygen (nitrox 50), or gas mixture composed of 1% nitrogen and 99% oxygen (nitrox 99) on bubble formation and vascular/endothelial function during decompression after self-contained underwater breathing apparatus diving.

Methods: This randomized controlled study, conducted in 2014, involved ten divers. Each diver performed three dives in a randomized protocol using three gases: air, nitrox 50, or nitrox 99 during ascent. The dives were performed on three different days limited to 45 m sea water (msw) depth with 20 min bottom time. Nitrogen bubbles formation was assessed by ultrasound detection after dive. Arterial/endothelial function was evaluated by brachial artery flow mediated dilatation (FMD) before and after dive.

Results: Nitrox 99 significantly reduced bubble formation after cough compared with air and nitrox 50 (grade 1 vs 3 and vs 3, respectively, P=0.026). Nitrox 50 significantly decreased post-dive FMD compared with pre-dive FMD (3.62 ± 5.57% vs 12.11 ± 6.82% P=0.010), while nitrox 99 did not cause any significant change.

Conclusion: Nitrox 99 reduced bubble formation, did not change post-dive FMD, and decreased total dive duration, indicating that it might better preserve endothelial function compared with air and nitrox 50 dive protocols.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Air
  • Brachial Artery / physiopathology
  • Decompression / methods*
  • Decompression Sickness / diagnostic imaging
  • Decompression Sickness / physiopathology
  • Decompression Sickness / prevention & control*
  • Diving / physiology*
  • Endothelium, Vascular / physiopathology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nitrogen / chemistry
  • Nitrogen / therapeutic use*
  • Oxygen / chemistry
  • Oxygen / therapeutic use*
  • Ultrasonography
  • Vasodilation

Substances

  • nitrox
  • Nitrogen
  • Oxygen