Wetenschappelijke artikelen
Geselecteerde wetenschappelijke artikelen over duikgeneeskunde en -fysiologie
2018 nov 1
Inert gas narcosis in scuba diving, different gases different reactions
Rocco M, Pelaia P, Di Benedetto P, Conte G, Maggi L, Fiorelli S, Mercieri M, Balestra C, De Blasi RA & Investigators RP

Purpose: Underwater divers face several potential neurological hazards when breathing compressed gas mixtures including nitrogen narcosis which can impact diver’s safety. Various human studies have clearly demonstrated brain impairment due to nitrogen narcosis in divers at 4 ATA using critical flicker fusion frequency (CFFF) as a cortical performance indicator. However, recently some authors have proposed a probable adaptive phenomenon during repetitive exposure to high nitrogen pressure in rats, where they found a reversal effect on dopamine release. Methods: Sixty experienced divers breathing Air, Trimix or Heliox, were studied during an open water dive to a depth of 6 ATA with a square profile testing CFFF measurement before (T0), during the dive upon arriving at the bottom (6 ATA) (T1), 20 min of bottom time (T2), and at 5 m (1.5 ATA) (T3).

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1998 jan 1
Intrathoracic pressure changes after Valsalva strain and other maneuvers: implications for divers with patent foramen ovale
Balestra C., Germonpré P., Marroni A.

Scuba divers with patent foramen ovale (PFO) may be at risk for paradoxical nitrogen gas emboli when performing maneuvers that cause a rebound blood loading to the right atrium. We measured the rise and fall in intrathoracic pressure (ITP) during various maneuvers in 15 divers. The tests were standard isometric exercises (control), forceful coughing, knee bend (with and without respiration blocked), and Valsalva maneuver (maximal, gradually increased to reach control ITP, and as performed by divers to equalize middle ear pressure). All the maneuvers, as well as the downward slope of ITP at the release phase, were related to the control value.

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2020 dec 20
Investigating critical flicker fusion frequency for monitoring gas narcosis in divers
Vrijdag XC, van Waart H, Sleigh JW, Balestra C, Mitchell SJ

Introduction: Critical flicker fusion frequency (CFFF) has been used in various studies to measure the cognitive effects of gas mixtures at depth, sometimes with conflicting or apparently paradoxical results. This study aimed to evaluate a novel automatic CFFF method and investigate whether CFFF can be used to monitor gas-induced narcosis in divers. Methods: Three hyperbaric chamber experiments were performed: 1) Automated and manual CFFF measurements during air breathing at 608 kPa (n = 16 subjects); 2) Manual CFFF measurements during air and heliox breathing at sea level (101.3 kPa) and 608 kPa (n = 12); 3) Manual CFFF measurements during oxygen breathing at sea level, 142 and 284 kPa (n = 10). All results were compared to breathing air at sea level.

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2014 jun 1
Just say NO to decompression bubbles: is there a real link between nitric oxide and bubble production or reduction in humans?
Balestra C.

Vascular gas emboli (VGE) start forming during the degassing of tissues in the decompression (ascent) phase of the dive when bubble precursors (micronuclei) are triggered to growth. The precise formation mechanism of micronuclei is still debated, with formation sites in facilitating regions with surfactants, hydrophobic surfaces or crevices. Ho wever, significant inter-subject variability to VGE exists for the same diving exposure and VGE may even be reduced with a single pre-dive intervention. The precise link between VGE and endothelial dysfunction observed post dive remains unclear and a nitric oxide (NO) mechanism has been hypothesized.

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2015 apr 1
Le “Paradoxe de l’Oxygène” un phénomène varié
Balestra C.

L'eau est une matière plurielle et ambivalente. Symboliquement associée à la purification, cause régulière de multiples ravages humains et écologiques, elle est aussi devenue un vaste terrain de jeu, d'expériences corporelles, d'immersions en tous genres. Retenir son souffle pour aller loin, profond, ou simplement rester longtemps immergé, passionne des pratiquants toujours plus nombreux. Il s'agit bien souvent de « se fondre » dans le milieu, repousser ses limites et surtout se reconnecter avec soi-même, explorer son propre corps et se sentir « bien ». L'apprentissage de l'apnée révèle les capacités d'adaptation du corps humain, actualisant des ressources inédites.

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