Citation

Bove AA. Am. J. Respir. Crit. Care Med. 2014; 189(12): 1479-1486.

Affiliation

Temple University School of Medicine, Cardiology, 3401 N. Broad St, Philadelphia, Pennsylvania, United States, 19140, 215-707-9259, 215-707-3946 ; alfred.bove@tuhs.temple.edu.

Copyright

(Copyright © 2014, American Thoracic Society)

DOI

10.1164/rccm.201309-1662CI

PMID

24869752

Abstract

Exposure to the undersea environment has unique effects on normal physiology and can result in unique disorders that require an understanding of the effects of pressure and inert gas supersaturation on organ function, and knowledge of the appropriate therapies that can include recompression in a hyperbaric chamber. Effects of Boyle's law result in changes in volume of gas containing spaces when exposed to the increased pressure underwater. These effects can cause middle ear and sinus injury, and lung barotrauma due to lung overexpansion during ascent from depth. Disorders related to diving have unique presentations, and understanding of the high pressure environment is needed to properly diagnose and manage these disorders. Breathing compressed air underwater results in increased dissolved intert gas in tissues and organs. On ascent following a diving exposure, the dissolved gas can achieve a supersaturated state, and form gas bubbles in blood and tissues with resulting tissue and organ damage. Decompression Sickness can involve the musculoskeletal system, skin, inner ear, brain and spnal cord with characteristic signs and symptoms. Usual therapy is recompression in a hyperbraic chamber following well established protocols. Many recreational diving candidates seek medical clearance for diving and knowledge of the environemtalal exposure and its effects on physiologic function is needed to properly assess individuals for fitness to dive. This review provides a basis for understanding the diving environment and its accompanying disorders as well as a basis for assessment of fitness for diving.

Language: en