Selected scientific publications on diving medicine and physiology.

2018 Sep 1
Decreased incidence of pulmonary barotrauma after discontinuation of emergency free ascent training
Lafère P, Germonpré P, Guerrero F, Marroni A, Balestra C.

Introduction: Because a significant association between training to perform emergency free ascent (EFA) and the occurrence of pulmonary barotrauma (PBT) was demonstrated in 2006, the Belgian Underwater Federation (BUF) decided to discontinue this procedure. An evaluation was needed 10 yr after the implementation of this change. Methods: All medical records with a diagnosis of PBT that occurred in Belgium from November 2006 to September 2016 were prospectively collected. Data on the proportion of in-water skills training dives were obtained from BUF.

Read more

2018 Aug 21
Hemoglobin and Erythropoietin After Commercial Saturation Diving
Kiboub FZ., Balestra C., Loennechen Ø., Eftedal I.

Saturation divers are exposed to elevated partial pressure of oxygen (ppO2) in their hyperbaric work environment. Experimental studies indicate that oxygen transport is altered, and we have previously reported a drop in hematocrit and extensive downregulation of genes involved in blood oxygen transport capacity after decompression from professional saturation diving. Here we investigate the initial period of hematological adjustment back to normobaric air after professional saturation diving. Erythropoietin (EPO) and hemoglobin (Hb) were measured in blood from 13 divers at two time-points after saturation assignments lasting up to 4 weeks; first immediately after decompression and again 24 h later. Pre-dive levels defined baselines.

Read more

2018 Aug 1
European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism
Pristipino C, Sievert H, D'Ascenzo F, Mas JL, Meier B, Scacciatella P, Hildick-Smith D, Gaita F, Toni D, Kyrle P, Thomson J, Derumeaux G, Onorato E, Sibbing D, Germonpre P, Berti S, Chessa M, Bedogni F, Dudek D, Hornung M, Zamorano J, European Association of Percutaneous Cardiovascular I, European Stroke O, European Heart Rhythm A, European Association for Cardiovascular I, Association for European P, Congenital C, GUCH ESCWgo, Thrombosis ESCWgo & European Haematological S.

The presence of a patent foramen ovale (PFO) is implicated in the pathogenesis of a number of medical conditions; however, the subject remains controversial and no official statements have been published. This interdisciplinary paper, prepared with involvement of eight European scientific societies, aims to review the available trial evidence and to define the principles needed to guide decision making in patients with PFO. In order to guarantee a strict process, position statements were developed with the use of a modified grading of recommendations assessment, development, and evaluation (GRADE) methodology. A critical qualitative and quantitative evaluation of diagnostic and therapeutic procedures was performed, including assessment of the risk/benefit ratio.

Read more

2018 Apr 3
Variability in circulating gas emboli after a same scuba diving exposure
Papadopoulou V., Germonpré P., Cosgrove D., Eckersley RJ., Dayton PA., Obeid G., Boutros A., Tang MX., Theunissen S., Balestra C.

PURPOSE: A reduction in ambient pressure or decompression from scuba diving can result in ultrasound-detectable venous gas emboli (VGE). These environmental exposures carry a risk of decompression sickness (DCS) which is mitigated by adherence to decompression schedules; however, bubbles are routinely observed for dives well within these limits and significant inter-personal variability in DCS risk exists. Here, we assess the variability and evolution of VGE for 2 h post-dive using echocardiography, following a standardized pool dive in calm warm conditions.

Read more

2018 Mar 31
Spirometry and oxidative stress after rebreather diving in warm water
Bosco G., Rizzato A., Quartesan S., Camporesi E., Mrakic-Sposta S., Moretti S., Balestra C., Rubini A.

Introduction: Hyperbaric oxygen (HBO₂) therapy and use of enriched air can result in oxidative injury affecting the brain, lungs and eyes. HBO₂ exposure during diving can lead to a decrease in respiratory parameters. However, the possible effects of acute exposure to oxygen-enriched diving on subsequent spirometric performance and oxidative state in humans have not been recently described recently. We aim to investigate possible effects of acute (i) hyperbaric and (ii) hyperbaric hyperoxic exposure using scuba or closed-circuit rebreather (CCR) on subsequent spirometry and to assess the role of oxidative state after hyperoxic diving.

Read more