RESUMEN

Head out water immersion (HOWI) induces ventilatory and hemodynamic changes, which may be a result of hydrostatic pressure, augmented arterial CO2 tension, or a combination of both. We hypothesized that the hydrostatic pressure and elevated CO2 tension that occur during HOWI will contribute to an augmented ventilatory sensitivity to CO2 and an attenuated cerebrovascular reactivity to CO2 during water immersion. Twelve subjects (age: 24±3 y, BMI: 25±3 kg/m2) completed HOWI, waist water immersion with CO2 (WWI+CO2), and WWI where a rebreathing test was conducted at baseline, 10, 30, and 60 minutes, and post. PETCO2, minute ventilation, expired gases, blood pressure, heart rate, and middle cerebral artery blood velocity were recorded continuously. PETCO2 increased throughout all visits (p£0.011), was matched during HOWI and WWI+CO2 (p³0.264), and was greater during WWI+CO2 vs. WWI at 10, 30, and 60 minutes (p<0.001). When HOWI vs. WWI+CO2 were compared, the change in ventilatory sensitivity to CO2 was different at 10 (0.59±0.34 vs. 0.06±0.23 L/min/mmHg, p<0.001), 30 (0.58±0.46 vs. 0.15±0.25 L/min/mmHg, p<0.001), and 60 minutes (0.63±0.45 vs. 0.16±0.34 L/min/mmHg, p<0.001), while there were no differences between conditions for cerebrovascular reactivity to CO2 (p³0.163). When WWI+CO2 vs. WWI were compared, ventilatory sensitivity to CO2 was not different between conditions (p³0.642), while the change in cerebrovascular reactivity to CO2 was different at 30 minutes (-0.56±0.38 vs. -0.30±0.25 cm/s/mmHg, p=0.010). These data indicate that during HOWI ventilatory sensitivity to CO2 increases due to the hydrostatic pressure, while cerebrovascular reactivity to CO2 decreases due to the combined effects of immersion.

RESUMEN

One of the reasons for the emergency use of a hyperbaric chamber concerns a diving-related accident. Decompression sickness is potentially serious; it requires urgent treatment and hyperbaric recompression. It is caused by the formation of nitrogen bubbles in the organism which appear during the diver's ascent and throughout his or her decompression.

Asunto(s)

RESUMEN

Decompression sickness in underwater diving exposes the diver to a risk of clinical sequelae which require specific care. In the absence of sequelae or after clinical recovery, the question of diving again may be raised. As part of a secondary prevention approach, the hyperbaric practitioner measures the physical, psychological and social impact of re-exposure to pressure and the immersion of the patient-diver.

Asunto(s)

RESUMEN

The number of recreational scuba divers is steadily increasing. In its latest recommendations, the French Federation of Undersea Studies and Sports listed congenital heart disease as a formal and final contraindication to scuba diving. On the other hand, with the progress made in their management, the prognosis and quality of life of patients with congenital heart diseases have improved considerably, enabling them to engage in physical and sports endeavours, which are known to confer general health and psychological benefits. As a consequence, the ability of these patients to dive has become a regular and recurrent issue. We review the various types of scuba diving, the physical performance required for its practice, its effects on cardiovascular function and the elements that need to be considered before recommending whether it can be practiced safely at various levels of difficulty. Because of the diversity and broad heterogeneity of congenital heart diseases, a detailed evaluation of each patient's performance based on clinical criteria common to all congenital heart diseases is recommended.

Asunto(s)