Exercise after SCUBA diving increases the incidence of arterial gas embolism

Arterialization of gas bubbles after decompression from scuba diving has traditionally been associated with pulmonary barotraumas or cardiac defects, such as the patent foramen ovale. Recent studies have demonstrated the right-to-left passage of bubbles through intrapulmonary arterial-venous anastam...

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Bibliographic Details
Published in:Journal of applied physiology (1985) 2013-09, Vol.115 (5), p.716-722
Main Authors: Madden, Dennis, Lozo, Mislav, Dujic, Zeljko, Ljubkovic, Marko
Format: Article
Language:English
Subjects:
Adult
Arteries - metabolism
Arteries - physiology
Blood Gas Analysis - methods
Diving - physiology
Embolism - metabolism
Embolism - physiopathology
Exercise
Exercise - physiology
Female
Foramen Ovale, Patent - metabolism
Foramen Ovale, Patent - physiopathology
Humans
Incidence
Male
Oxygen
Oxygen - metabolism
Scuba & skin diving
Ultrasonic imaging
Veins & arteries
Veins - metabolism
Veins - physiology
Young Adult
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Summary:Arterialization of gas bubbles after decompression from scuba diving has traditionally been associated with pulmonary barotraumas or cardiac defects, such as the patent foramen ovale. Recent studies have demonstrated the right-to-left passage of bubbles through intrapulmonary arterial-venous anastamoses (IPAVA) that allow blood to bypass the pulmonary microcirculation. These passages open up during exercise, and the aim of this study is to see if exercise in a postdiving period increases the incidence of arterialization. After completing a dive to 18 m for 47 min, patent foramen ovale-negative subjects were monitored via transthoracic echocardiography, within 10 min after surfacing, for bubble score at rest. Subjects then completed an incremental cycle ergometry test to exhaustion under continuous transthoracic echocardiography observation. Exercise was suspended if arterialization was observed and resumed when the arterialization cleared. If arterialization was observed a second time, exercise was terminated, and oxygen was administered. Out of 23 subjects, 3 arterialized at rest, 12 arterialized with exercise, and 8 did not arterialize at all even during maximal exercise. The time for arterialization to clear with oxygen was significantly shorter than without. Exercise after diving increased the incidence of arterialization from 13% at rest to 52%. This study shows that individuals are capable of arterializing through IPAVA, and that the intensity at which these open varies by individual. Basic activities associated with SCUBA diving, such as surface swimming or walking with heavy equipment, may be enough to allow the passage of venous gas emboli through IPAVA.
ISSN:8750-7587
1522-1601
DOI:10.1152/japplphysiol.00029.2013