Association Between Arterial Oxygen Saturation and Lung Ultrasound B-Lines After Competitive Deep Breath-Hold Diving

Patrician, Alexander; Pernett, Frank; Lodin-Sundström, Angelica; Schagatay, Erika

doi:10.3389/fphys.2021.711798

Cited by 10 publications

(3 citation statements)

References 64 publications

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“…Auscultation may demonstrate rales or crackles. Pulse oximetry >95% within 30 minutes of surfacing has a negative predictive value of 100% for lung injury (29). Ultrasound may demonstrate lung comets and areas of atelectasis (30).…”

Section: Medical Issues In Breath-hold Divingmentioning

confidence: 99%

Breath-Hold Diving Injuries — A Primer for Medical Providers

Yu,

Valdivia-Valdivia,

Silva

et al. 2024

Curr Sports Med Rep

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Breath-hold divers, also known as freedivers, are at risk of specific injuries that are unique from those of surface swimmers and compressed air divers. Using peer-reviewed scientific research and expert opinion, we created a guide for medical providers managing breath-hold diving injuries in the field. Hypoxia induced by prolonged apnea and increased oxygen uptake can result in an impaired mental state that can manifest as involuntary movements or full loss of consciousness. Negative pressure barotrauma secondary to airspace collapse can lead to edema and/or hemorrhage. Positive pressure barotrauma secondary to overexpansion of airspaces can result in gas embolism or air entry into tissues and organs. Inert gas loading into tissues from prolonged deep dives or repetitive shallow dives with short surface intervals can lead to decompression sickness. Inert gas narcosis at depth is commonly described as an altered state similar to that experienced by compressed air divers. Asymptomatic cardiac arrhythmias are common during apnea, normally reversing shortly after normal ventilation resumes. The methods of glossopharyngeal breathing (insufflation and exsufflation) can add to the risk of pulmonary overinflation barotrauma or loss of consciousness from decreased cardiac preload. This guide also includes information for medical providers who are tasked with providing medical support at an organized breath-hold diving event with a list of suggested equipment to facilitate diagnosis and treatment outside of the hospital setting.

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Section: Medical Issues In Breath-hold Divingmentioning

confidence: 99%

Breath-Hold Diving Injuries — A Primer for Medical Providers

Yu,

Valdivia-Valdivia,

Silva

et al. 2024

Curr Sports Med Rep

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“…There is also evidence that barotrauma may be more common than reported. Patrician et al ( 2021 ) recently confirmed by ultrasound that remaining low SpO 2 after deep dives reflected lung fluid accumulation.…”

Section: Introductionmentioning

confidence: 97%

Unlocking the depths: multiple factors contribute to risk for hypoxic blackout during deep freediving

et al. 2023

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Purpose To examine the effect of freediving depth on risk for hypoxic blackout by recording arterial oxygen saturation (SpO2) and heart rate (HR) during deep and shallow dives in the sea. Methods Fourteen competitive freedivers conducted open-water training dives wearing a water-/pressure proof pulse oximeter continuously recording HR and SpO2. Dives were divided into deep (> 35 m) and shallow (10–25 m) post-hoc and data from one deep and one shallow dive from 10 divers were compared. Results Mean ± SD depth was 53 ± 14 m for deep and 17 ± 4 m for shallow dives. Respective dive durations (120 ± 18 s and 116 ± 43 s) did not differ. Deep dives resulted in lower minimum SpO2 (58 ± 17%) compared with shallow dives (74 ± 17%; P = 0.029). Overall diving HR was 7 bpm higher in deep dives (P = 0.002) although minimum HR was similar in both types of dives (39 bpm). Three divers desaturated early at depth, of which two exhibited severe hypoxia (SpO2 ≤ 65%) upon resurfacing. Additionally, four divers developed severe hypoxia after dives. Conclusions Despite similar dive durations, oxygen desaturation was greater during deep dives, confirming increased risk of hypoxic blackout with increased depth. In addition to the rapid drop in alveolar pressure and oxygen uptake during ascent, several other risk factors associated with deep freediving were identified, including higher swimming effort and oxygen consumption, a compromised diving response, an autonomic conflict possibly causing arrhythmias, and compromised oxygen uptake at depth by lung compression possibly leading to atelectasis or pulmonary edema in some individuals. Individuals with elevated risk could likely be identified using wearable technology.

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“…With this perspective, POCUS has been used to detect venous gas emboli traveling from peripheral circulation to the heart when resurfacing after self-contained underwater breathing apparatus (SCUBA) dives [9,10] and signs of pulmonary edema after breath-hold diving (BHD) [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of chest ultrasound up to 42 m underwater

Paganini,

Cantarella,

Cialoni

et al. 2023

Ultrasound J

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After recent advancements, ultrasound has extended its applications from bedside clinical practice to wilderness medicine. Performing ultrasound scans in extreme environments can allow direct visualization of unique pathophysiological adaptations but can be technically challenging. This paper summarizes how a portable ultrasound apparatus was marinized to let scientific divers and sonographers perform ultrasound scans of the lungs underwater up to − 42 m. A metallic case protected the ultrasound apparatus inside; a frontal transparent panel with a glove allowed visualization and operation of the ultrasound by the diving sonographer. The inner pressure was equalized with environmental pressure through a compressed air tank connected with circuits similar to those used in SCUBA diving. Finally, the ultrasound probe exited the metallic case through a sealed aperture. No technical issues were reported after the first testing step and the real experiments.

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Association Between Arterial Oxygen Saturation and Lung Ultrasound B-Lines After Competitive Deep Breath-Hold Diving

Cited by 10 publications

References 64 publications

Breath-Hold Diving Injuries — A Primer for Medical Providers

Breath-Hold Diving Injuries — A Primer for Medical Providers

Unlocking the depths: multiple factors contribute to risk for hypoxic blackout during deep freediving

Feasibility of chest ultrasound up to 42 m underwater

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