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Thread: Do's and Don'ts for DCS Prevention

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    Do's and Don'ts for DCS Prevention

    AddHelium just completed an Expeditionary Dive Seminar in Grand Cayman. A four-day lecture series reporting on the latest scientific research results on DCS was part of it. Some of the results and precautions we divers can take have been posted on AddHelium's Medical Corner website: Not Found - Add Helium

    Safe diving!

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    Re: Do's and Don'ts for DCS Prevention

    Try this one

    LINK
    .
    I guarantee that if you CLICK HERE you will not have your view blocked by clothing





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    Re: Do's and Don'ts for DCS Prevention

    Mild exercise during deco you say?

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    Re: Do's and Don'ts for DCS Prevention

    Quote Originally Posted by quickean  View Original Post
    Mild exercise during deco you say?
    Yes, it appears that by increasing your cardiac output, you also increase perfusion which will help with off-gassing better.

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    Re: Do's and Don'ts for DCS Prevention

    Quote Originally Posted by Dsix36  View Original Post
    Try this one

    LINK
    Thank you Don!! You got to show me how to do this.

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    Re: Do's and Don'ts for DCS Prevention

    Claudia, it'd be nice to see the evidence/references for each bullet. Maybe thats a separate page?

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    Re: Do's and Don'ts for DCS Prevention

    The seminar material was comprised of 86 scientific papers from 2000-2012.
    What you have below is obviously only a few of them.

    I was reluctant to post the references, because most people only read the headline, make a conclusion without ever having read the article itself. Some headlines are misleading. Also, when reading scientific papers, one has to be aware of any potential biases. Some papers/results are "stronger" than others. These papers need to be read and evaluated, as well as cross-referenced.

    The DCS Prevention points posted have been comprised by far more papers than the ones listed below. Please keep that in mind.

    Exercise and Hydration:

    Blatteau, JE et al – Aerobic exercise 2 hours before a dive to 30 msw decreases bubble formation after decompression
    Aviat Space Environ Med 2005; 76: no 7

    Blatteau, JE et al – Predive sauna and venous gas bubbles upon decompression from 400 kPa
    Aviat Space Environ Med 2008; 79: 1100-5

    Castagna, O et al - Endurance exercise immediately before sea diving decreases bubble formation
    Eur J Appl Physiol 2011; 111: 1047-54

    Greasy Food and Body Fat:

    Brubakk AO, et al – The role of intra-vascular bubbles and the vascular endothelium in decompression sickness – review
    Diving and Hyperbaric Medicine 2009; 39:162-9

    Carturan D, et al – Ascent rate, age maximal oxygen uptake, adiposity, and circulating venous bubbles after diving.
    J Appl Physiol 2002; 93: 1349-56

    Duplessis CA, et al - Prophylactic statins as a possible method to decrease bubble formation in diving.
    Aviat Space Environ Med 2007; 78: 430-4

    Antioxidants:

    Obad A, et al - Antioxidant pretreatment and reduced art endothelial dysfunction after diving
    Av Space Env Med 2007; 78:1114-1120

    Mak S, et al – Vitamin C prevents hyperoxia-mediated vasoconstriction and impairment of endothelium-dependent vasodilation
    Am j Physiol Heart Circ Physiol 2002; 282: H2414-21

    Safe Diving!
    Claudia Roussos

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    Re: Do's and Don'ts for DCS Prevention

    Quote Originally Posted by dreamdive  View Original Post
    The seminar material was comprised of 86 scientific papers from 2000-2012.
    What you have below is obviously only a few of them.

    I was reluctant to post the references, because most people only read the headline, make a conclusion without ever having read the article itself. Some headlines are misleading. Also, when reading scientific papers, one has to be aware of any potential biases. Some papers/results are "stronger" than others. These papers need to be read and evaluated, as well as cross-referenced.

    The DCS Prevention points posted have been comprised by far more papers than the ones listed below. Please keep that in mind.

    Exercise and Hydration:

    Blatteau, JE et al – Aerobic exercise 2 hours before a dive to 30 msw decreases bubble formation after decompression
    Aviat Space Environ Med 2005; 76: no 7

    Blatteau, JE et al – Predive sauna and venous gas bubbles upon decompression from 400 kPa
    Aviat Space Environ Med 2008; 79: 1100-5

    Castagna, O et al - Endurance exercise immediately before sea diving decreases bubble formation
    Eur J Appl Physiol 2011; 111: 1047-54

    Greasy Food and Body Fat:

    Brubakk AO, et al – The role of intra-vascular bubbles and the vascular endothelium in decompression sickness – review
    Diving and Hyperbaric Medicine 2009; 39:162-9

    Carturan D, et al – Ascent rate, age maximal oxygen uptake, adiposity, and circulating venous bubbles after diving.
    J Appl Physiol 2002; 93: 1349-56

    Duplessis CA, et al - Prophylactic statins as a possible method to decrease bubble formation in diving.
    Aviat Space Environ Med 2007; 78: 430-4

    Antioxidants:

    Obad A, et al - Antioxidant pretreatment and reduced art endothelial dysfunction after diving
    Av Space Env Med 2007; 78:1114-1120

    Mak S, et al – Vitamin C prevents hyperoxia-mediated vasoconstriction and impairment of endothelium-dependent vasodilation
    Am j Physiol Heart Circ Physiol 2002; 282: H2414-21

    Safe Diving!
    Claudia Roussos
    Thanks for those references. Are those Journals accessible to the public or must I be a member of an Institute to gain access??

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    Re: Do's and Don'ts for DCS Prevention

    Hello Claudia,

    I note your very appropriate caveat about the frequently poor strength of evidence for some of these strategies. I would also like to say that I agree with virtually all of your advice in general. None of it is likely to be harmful.

    However, I think that in the interests of accuracy you should be clear that none of the studies you have cited present evidence for "prevention of DCS". At best, the most relevant ones are very small studies that demonstrate a reduction in venous bubble formation as a result of some intervention (eg exercise prior to diving). This does not necessarily translate into a reduction in the risk of DCS (though I agree it is encouraging). At worst, the evidence is virtually non-existent (eg the studies you cite in support of your claim not to eat fatty meals really don't address that issue at all).

    To my knowledge, if we put aside repair of a large right to left shunt, only the NEDU temperature manipulation study [1] has actually demonstrated that risk of DCS in humans can be (markedly) influenced by a physiological intervention. I would have thought that temperature stability would be a very worthy inclusion in your list of strategies.

    Simon M

    Reference:

    1. Gerth WA, Ruterbusch VL, Long ET. The influence of thermal exposure on diver susceptibility to decompression sickness. NEDU TR 06-07; 2007

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    Re: Do's and Don'ts for DCS Prevention

    Quote Originally Posted by Simon Mitchell  View Original Post
    Hello Claudia,

    I note your very appropriate caveat about the frequently poor strength of evidence for some of these strategies. I would also like to say that I agree with virtually all of your advice in general. None of it is likely to be harmful.

    However, I think that in the interests of accuracy you should be clear that none of the studies you have cited present evidence for "prevention of DCS". At best, the most relevant ones are very small studies that demonstrate a reduction in venous bubble formation as a result of some intervention (eg exercise prior to diving). This does not necessarily translate into a reduction in the risk of DCS (though I agree it is encouraging). At worst, the evidence is virtually non-existent (eg the studies you cite in support of your claim not to eat fatty meals really don't address that issue at all).

    To my knowledge, if we put aside repair of a large right to left shunt, only the NEDU temperature manipulation study [1] has actually demonstrated that risk of DCS in humans can be (markedly) influenced by a physiological intervention. I would have thought that temperature stability would be a very worthy inclusion in your list of strategies.

    Simon M

    Reference:

    1. Gerth WA, Ruterbusch VL, Long ET. The influence of thermal exposure on diver susceptibility to decompression sickness. NEDU TR 06-07; 2007
    Dear Simon!

    Thank you for joining the discussion! An even greater thank you for supplying me with this new venue on DCS and temperature. I have not come across it! Not surprisingly, since I lack the arrogance to think that over the past 5 months I was able to research it all. So any feedback and new leads on the subject is greatly appreciated.

    If you get a chance and read (or reread) the disclaimer of the original on AddHelium's webpage, you will note that I stated that we don't have scientific prevention strategies written in stone. What I gave were suggestions for DCS prevention based on various studies. As you know, it is very difficult to conduct studies on humans that will meet scientific ethical standards. You might want to agree that this is one of the reasons why we don't have a lot of answers since we cannot intentionally bend humans like we can rats or rabbits (or swine). The thermal study had subjects bending, however, this was incidental rather than intentional. As to the fat intake, I hope that the scientific community will design more and better studies to research any causal relationships. Meanwhile, the evidence at present has value and I don't see any harm done avoiding a fatty meal prior to diving. The relationship to fat intake alone or fitness level needs to be delineated in future studies.

    Again, thank you for this lead and hopefully, as a lead researcher in the field, you will be able to supply me with more in the future.

    Claudia

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