Reliability of venous gas embolism detection in the subclavian area for decompression stress assessment following scuba diving.

Autor:	Hugon J; Corresponding author: Azoth Systems - Technopôle de la Mer, 93 Forum de la Méditerranée, 83190 Ollioules, France, julien.hugon@azoth-systems.fr., Metelkina A; Azothe Systems - Technopôle de la Mer, Ollioules, France., Barbaud A; Azothe Systems - Technopôle de la Mer, Ollioules, France., Nishi R; Defence Research and Development Canada, Toronto Research Centre (retired), Toronto, ON, Canada., Bouak F; Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada., Blatteau JE; Institut de Recherche Biomédicale des Armées, Équipe de Recherche Subaquatique Opérationnelle, Toulon, France., Gempp E; French Navy Diving School, Toulon, France.
Jazyk:	angličtina
Zdroj:	Diving and hyperbaric medicine [Diving Hyperb Med] 2018 Sep 30; Vol. 48 (3), pp. 132-140.
DOI:	10.28920/dhm48.3.132-140
Abstrakt:	Introduction: Ultrasonic detection of venous gas emboli (VGE) in the precordial (PRE) region is commonly used in evaluation of decompression stress. While subclavian (SC) VGE detection can also be used to augment and improve the evaluation, no study has rigorously compared VGE grades from both sites as decompression stress indicators. Methods: This retrospective study examined 1,016 man-dives breathing air extracted from the Defence Research and Development Canada dataset. Data for each man-dive included dive parameters (depth, bottom time, total ascent time), PRE and SC VGE grades (Kisman-Masurel) and post-dive decompression sickness (DCS) status. Correlation between SC and PRE grades was analyzed and the association of the probability of DCS (pDCS) with dive parameters and high bubble grades (HBG III- to IV) was modelled by logistic regression for SC and PRE separately for DCS risk ratio comparisons. Results: PRE and SC VGE grades were substantially correlated (R = 0.66) and were not statistically different (p = 0.61). For both sites, pDCS increased with increasing VGE grade. When adjusted for dive parameters, the DCS risk was significantly associated with HBG for both PRE (p = 0.03) and SC (p < 0.001) but the DCS risk ratio for SC HBG (RR = 6.0, 95% CI [2.7-12.3]) was significantly higher than for PRE HBG (RR = 2.6, 95% CI [1.1-6.0]). Conclusions: The association of bubble grades with DCS occurrence is stronger for SC than PRE when exposure severity is taken into account. The usefulness of SC VGE in decompression stress evaluation has been underestimated in the past. (Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu