Terrain experiments for avalanche survival research require appropriate snow conditions, which may not be available year round. To prepare these experiments and test the protocol, it might be advantageous to test them in a laboratory with a snow model. The aim of the study was to find a material that can be used to simulate avalanche snow for studying gas exchange of a person covered with avalanche snow. Three loose porous materials (perlite, wood shavings and polystyrene) were tested in two forms—dry and moisturized. Each volunteer underwent six phases of the experiment in random order (three materials each dry or moisturized) during experimental breathing into the tested materials. Physiological parameters and fractions of oxygen and carbon dioxide in the airways were recorded continuously. All the materials selected as possible models of the avalanche snow negatively affected gas exchange during the breathing of the volunteers in a very similar extent. The time courses of the recorded parameters were very similar and were bordered from one side by the wet perlite and from the other side by the dry perlite. Therefore, other tested materials may be substituted with perlite with and appropriate water content. From all the tested materials, perlite is the best to simulate avalanche snow because of its homogeneity, reproducibility and easy manipulation.
Noninvasive techniques are routinely used for assessment of tissue effects of lung ventilation. However, comprehensive studies of the response time of the methods are scarce. The aim of this study was to compare the response time of noninvasive methods for monitoring of gas exchange to sudden changes in the composition of the inspired gas. A prospective experimental study with 16 healthy volunteers was conducted. A ventilation circuit was designed that enabled a fast change in the composition of the inspiratory gas mixture while allowing spontaneous breathing. The volunteers inhaled a hypoxic mixture, then a hypercapnic mixture, a hyperoxic mixture and finally a 0.3% CO mixture. The parameters with the fastest response to the sudden change of O2 in inhaled gas were peripheral capillary oxygen saturation (SpO2) and regional tissue oxygenation (rSO2). Transcutaneous oxygen partial pressure (tcpO2) had almost the same time of reaction, but its time of relaxation was 2-3 times longer. End-tidal carbon dioxide (EtCO2) response time to change of CO2 concentration in inhaled gas was less than half in comparison with transcutaneous carbon dioxide partial pressure (tcpCO2). All the examined parameters and devices reacted adequately to changes in gas concentration in the inspiratory gas mixture.
Outdoor breathing trials with simulated avalanche snow are fundamental for the research of the gas exchange under avalanche snow, which supports the development of the international resuscitation guidelines. However, these studies have to face numerous problems, including unstable weather and variable snow properties. This pilot study examines a mineral material perlite as a potential snow model for studies of ventilation and gas exchange parameters. Thirteen male subjects underwent three breathing phases—into snow, wet perlite and dry perlite. The resulting trends of gas exchange parameters in all tested materials were similar and when there was a significant difference observed, the trends in the parameters for high density snow used in the study lay in between the trends in dry and wet perlite. These findings, together with its stability and accessibility year-round, make perlite a potential avalanche snow model material. Perlite seems suitable especially for simulation and preparation of breathing trials assessing gas exchange under avalanche snow, and potentially for testing of new avalanche safety equipment before their validation in real snow.The study was registered in ClinicalTrials.gov on January 22, 2018; the registration number is NCT03413878.
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