Risk assessment of SWEN21 a suggested new dive table for the Swedish armed forces: bubble grades by ultrasonography.

Autor:	Hjelte C; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden.; Swedish Armed Forces Diving and Naval Medicine Center, Swedish Armed Forces, Karlskrona, Sweden.; Sahlgrenska University Hospital, Anesthesia and Intensive Care, Gothenburg, Sweden.; Corresponding author: Dr Carl Hjelte, Kungsladugårdsgatan 113B. 414 76, Gothenburg, Sweden, ORCiD: 0009-0009-5522-8735, carl_hjelte@hotmail.com., Plogmark O; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden.; Swedish Armed Forces Diving and Naval Medicine Center, Swedish Armed Forces, Karlskrona, Sweden., Silvanius M; Swedish Armed Forces Diving and Naval Medicine Center, Swedish Armed Forces, Karlskrona, Sweden.; Blekinge Institute of Technology, Department of Mathematics and Natural Science, Karlskrona, Sweden., Ekström M; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden., Frånberg O; Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Respiratory Medicine and Allergology, Lund, Sweden.; Blekinge Institute of Technology, Department of Mathematics and Natural Science, Karlskrona, Sweden.
Jazyk:	angličtina
Zdroj:	Diving and hyperbaric medicine [Diving Hyperb Med] 2023 Dec 20; Vol. 53 (4), pp. 299-305.
DOI:	10.28920/dhm53.4.299-305
Abstrakt:	Introduction: To develop the diving capacity in the Swedish armed forces the current air decompression tables are under revision. A new decompression table named SWEN21 has been created to have a projected risk level of 1% for decompression sickness (DCS) at the no stop limits. The aim of this study was to evaluate the safety of SWEN21 through the measurement of venous gas emboli (VGE) in a dive series. Methods: A total 154 dives were conducted by 47 divers in a hyperbaric wet chamber. As a proxy for DCS risk serial VGE measurements by echocardiography were conducted and graded according to the Eftedal-Brubakk scale. Measurements were done every 15 minutes for approximately 2 hours after each dive. Peak VGE grades for the different dive profiles were used in a Bayesian approach correlating VGE grade and risk of DCS. Symptoms of DCS were continually monitored. Results: The median (interquartile range) peak VGE grade after limb flexion for a majority of the time-depth combinations, and of SWEN21 as a whole, was 3 (3-4) with the exception of two decompression profiles which resulted in a grade of 3.5 (3-4) and 4 (4-4) respectively. The estimated risk of DCS in the Bayesian model varied between 4.7-11.1%. Three dives (2%) resulted in DCS. All symptoms resolved with hyperbaric oxygen treatment. Conclusions: This evaluation of the SWEN21 decompression table, using bubble formation measured with echocardiography, suggests that the risk of DCS may be higher than the projected 1%. (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
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