Massive bubble formation after diving can lead to decompression sickness (DCS), which can result in neurological disorders. We demonstrated that hydrogen production from intestinal fermentation could exacerbate DCS in rats fed with a standard diet. The aim of this study is to identify a fecal metabolomic signature that may result from the effects of a provocative hyperbaric exposure. The fecal metabolome was studied in two groups of rats previously fed with maize or soy in order to account for diet effects. 64 animals, weighing 379.0_20.2 g on the day of the dive, were exposed to the hyperbaric protocol. The rats were separated into two groups: 32 fed with maize (Div MAIZE) and 32 fed with soy (Div SOY). Gut fermentation before the dive was estimated by measuring exhaled hydrogen. Following hyperbaric exposure, we assessed for signs of DCS. Blood was analyzed to assay inflammatory cytokines. Conventional and ChemRICH approaches helped the metabolomic interpretation of the cecal content. The effect of the diet is very marked at the metabolomic level, a little less in the blood tests, without this appearing strictly in the clinic status. Nevertheless, 37 of the 184 metabolites analyzed are linked to clinical status. 35 over-expressed compounds let suggest less intestinal absorption, possibly accompanied by an alteration of the gut microbial community, in DCS. The decrease in another metabolite suggests hepatic impairment. This spectral difference of the ceca metabolomes deserves to be studied in order to check if it corresponds to functional microbial particularities.
BackgroundImmersion pulmonary edema is potentially a catastrophic condition; however, the pathophysiological mechanisms are ill-defined. This study assessed the individual and combined effects of exertion and negative pressure breathing on the cardiovascular system during the development of pulmonary edema in SCUBA divers.MethodsSixteen male professional SCUBA divers performed four SCUBA dives in a freshwater pool at 1 m depth while breathing air at either a positive or negative pressure both at rest or with exercise. Echocardiography and lung ultrasound were used to assess the cardiovascular changes and lung comet score (a measure of interstitial pulmonary edema).ResultsThe ultrasound lung comet score was 0 following both the dives at rest regardless of breathing pressure. Following exercise, the mean comet score rose to 4.2 with positive pressure breathing and increased to 15.1 with negative pressure breathing. The development of interstitial pulmonary edema was significantly related to inferior vena cava diameter, right atrial area, tricuspid annular plane systolic excursion, right ventricular fractional area change, and pulmonary artery pressure. Exercise combined with negative pressure breathing induced the greatest changes in these cardiovascular indices and lung comet score.ConclusionsA diver using negative pressure breathing while exercising is at greatest risk of developing interstitial pulmonary edema. The development of immersion pulmonary edema is closely related to hemodynamic changes in the right but not the left ventricle. Our findings have important implications for divers and understanding the mechanisms of pulmonary edema in other clinical settings.
Seven healthy young men participated in six trials with three different types of local cooling [cool air breathing (CAB), face skin cooling (FaC), and combined cooling (CoC)] in a warm environment for 90 min while either resting (operative temperature: T(0) = 40 degrees C, dew point temperature: T(dp) = 15 degrees C, air velocity: v(a) = 0.3 m x s(-1)) or exercising on a cycle ergometer with an external work load of 90 W (T(0) = 36 degrees C, T(dp) = 15 degrees C, v(a) = 0.3 m x s(-1)). Cool air (10 degrees C) arrived at the entry point of the hood and/or the mask at a ventilation rate of 12 m x s(-1). Oesophageal temperature was not affected by any kind of cooling, while tympanic temperature was decreased at rest by both FaC and CoC [respectively -0.15 (0.06) and -0.09 (0.03) degrees C, P = 0.05]. Mean skin temperature was decreased by FaC and CoC at rest [respectively -0.31 (0.07) and -0.27 (0.09) degrees C, P = 0. 05] and during exercise [respectively -0.64 (0.15) and -1.04 (0.22) degrees C, P = 0.01]. CAB had no effect on skin temperatures. CoC and FaC reduced head skin temperature during both rest and work (P < 0.001) with no effect on the skin temperature of the rest of the body, except under CoC with exercise (P < 0.05). CAB did not influence local sweating. FaC, however, decreased the more profuse sweat rates (P = 0.05) at rest, while CoC decreased all sweating rates at rest (P = 0.05) and only the back, head and leg sweating rates during exercise (P = 0.05). These results suggest that head skin cooling causes a reduction in heat strain, while CAB does not. This beneficial influence does not, however, appear to be the result of selective brain cooling. Tympanic temperature seems to be a good index of the core thermal inputs to the hypothalamic regulatory system, since variations in that parameter were associated with similarly directed variations in the sweating outputs.
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