Oxygen, the lung and the diver: friends and foes?

Abstract

Worldwide, the number of professional and sports divers is increasing. Most of them breathe diving gases with a raised partial pressure of oxygen (PO 2 ). However, if the PO 2 is between 50 and 300 kPa (375-2250 mmHg) (hyperoxia), pathological pulmonary changes can develop, known as pulmonary oxygen toxicity (POT). Although in its acute phase, POT is reversible, it can ultimately lead to non-reversible pathological changes. Therefore, it is important to monitor these divers to prevent them from sustaining irreversible lesions.This review summarises the pulmonary pathophysiological effects when breathing oxygen with a PO 2 of 50-300 kPa (375-2250 mmHg). We describe the role and the limitations of lung function testing in monitoring the onset and development of POT, and discuss new techniques in respiratory medicine as potential markers in the early development of POT in divers. @ERSpublications To prevent the early development of pulmonary oxygen toxicity divers must be properly monitored

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Oxygen Toxicity and Special Operations Forces Diving: Hidden and Dangerous

“…The current prediction model (UPTD) was developed in dry setting during a time when capabilities to measure lung parameters were limited. Newer parameters, such as, the ratio between diffusion capacity of carbon monoxide and nitric oxide (DL NO/CO ), fraction of exhaled nitric oxide (FE NO ) or volatile organic compounds (VOCs), might be more accurate in determining POT, but these tests have yet to be validated (Shykoff, 2008a,b; Caspersen et al, 2011; van Ooij et al, 2014b,a, 2016; Vermeulen et al, 2016). Especially the VOCs are of interest because, in the field of pulmonology, this noninvasive diagnostic modality is increasingly utilized for diagnosing asthma, acute respiratory distress syndrome and lung cancer (Bos et al, 2014, 2016; Boots et al, 2015).…”