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1.
Bratisl Lek Listy ; 123(2): 77-82, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35065581

RESUMO

INTRODUCTION: Patent foramen ovale (PFO) is a risk factor of decompression sickness (DCS). However, data on risk stratification of divers with a PFO are sparse. This study sought to evaluate the risk of neurological DCS (DCSneuro), based on the presence and grade of a right-to-left shunt (RLS). METHODS: A total of 640 divers were screened for a RLS using TCD between 1/2006 and 4/2017. RLS was graded as low, medium, or high grade with two subgroups - after a Valsalva maneuver or at rest. Divers were questioned about their DCS history. Survival analysis techniques were used to assess risk factors for unprovoked DCS. RESULTS: A RLS was found in 258 divers (40.3 %). 44 (17.1 %) divers with a RLS experienced DCSneuro compared to 5 (1.3 %) divers without a RLS (p <0.001). The proportion of DCSneuro increased from 4.6 % in the low-grade RLS subgroup to 57.1 % in the subgroup with high-grade RLS at rest. The hazard ratio for DCSneuro and RLS was11.806 (p <0.001). CONCLUSIONS: Divers with a RLS had a higher risk of DCSneuro and the risk increased with RLS grade. We suggest that TCD is an appropriate method for RLS screening and risk stratification in divers (Tab. 4, Fig. 2, Ref. 29).


Assuntos
Doença da Descompressão , Mergulho , Forame Oval Patente , Doença da Descompressão/epidemiologia , Doença da Descompressão/etiologia , Mergulho/efeitos adversos , Forame Oval Patente/complicações , Forame Oval Patente/diagnóstico por imagem , Forame Oval Patente/epidemiologia , Humanos , Medição de Risco , Fatores de Risco
2.
Medicina (Kaunas) ; 58(1)2022 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-35056403

RESUMO

Background and Objectives: Vascular cell adhesion molecule-1 (VCAM-1) was identified as a cell adhesion molecule that helps to regulate inflammation-associated vascular adhesion and the transendothelial migration of leukocytes, such as macrophages and T cells. VCAM-1 is expressed by the vascular system and can be induced by reactive oxygen species, interleukin 1 beta (IL-1ß) or tumor necrosis factor alpha (TNFα), which are produced by many cell types. The newest data suggest that VCAM-1 is associated with the progression of numerous immunological disorders, such as rheumatoid arthritis, asthma, transplant rejection and cancer. The aim of this study was to analyze the increase in VCAM-1 expression and the impact of exposure in a hyperbaric chamber to VCAM-1 levels in human blood serum. Materials and Methods: The study included 92 volunteers. Blood for the tests was taken in the morning, from the basilic vein of fasting individuals, in accordance with the applicable procedure for blood collection for morphological tests. In both groups of volunteers, blood was collected before and after exposure, in heparinized tubes to obtain plasma and hemolysate, and in clot tubes to obtain serum. The level of VCAM-1 was determined using the immunoenzymatic ELISA method. Results: The study showed that the difference between the distribution of VCAM-1 before and after exposure corresponding to diving at a depth of 30 m was at the limit of statistical significance in the divers group and that, in most people, VCAM-1 was higher after exposure. Diving to a greater depth had a much more pronounced impact on changes in VCAM-1 values, as the changes observed in the VCAM-1 level as a result of diving to a depth of 60 m were statistically highly significant (p = 0.0002). The study showed an increase in VCAM-1 in relation to the baseline value, which reached as much as 80%, i.e., VCAM-1 after diving was almost twice as high in some people. There were statistically significant differences between the results obtained after exposure to diving conditions at a depth of 60 m and the values measured for the non-divers group. The leukocyte level increased statistically after exposure to 60 m. In contrast, hemoglobin levels decreased in most divers after exposure to diving at a depth of 30 m (p = 0.0098). Conclusions: Exposure in the hyperbaric chamber had an effect on serum VCAM-1 in the divers group and non-divers group. There is a correlation between the tested morphological parameters and the VCAM-1 level before and after exposure in the divers group and the non-divers group. Exposure may result in activation of the endothelium.


Assuntos
Mergulho/fisiologia , Oxigenação Hiperbárica , Molécula 1 de Adesão de Célula Vascular/sangue , Adesão Celular , Moléculas de Adesão Celular , Estudos Transversais , Humanos
4.
J Environ Manage ; 302(Pt A): 113997, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34710760

RESUMO

When effectively managed, Marine Protected Areas (MPAs) can produce wide ecosystem benefits that can foster, directly and indirectly, local economies. Tourism is one of the sectors mainly benefited by the effect of conservation. SCUBA diving represents an important tourism activity, especially in the context of MPAs, where it is one of the few activities often fostered rather than limited, for its capacity to integrate environmental and socio-economic sustainability. However, SCUBA diving can also produce negative impacts on the environment when tourism frequentation exceeds a sustainable threshold, these potentially generating negative effects on the sector itself. In this study, we (1) investigated the impact of SCUBA diving in one of the most frequented diving areas of the Mediterranean Sea (Cabo de Palos - Islas Hormigas marine reserve), and (2) assessed the potential benefits over time related to the adoption of a regulation change for the diving activity (i.e., formally adoption of diving quotas). Specifically, we compared demographic (density of alive and dead colonies) and morphometric (height, width and complexity) characteristics of the false coral (Myriapora truncata) between dived and fully protected (non-dived) locations over four diving seasons (one before and three after the change in diving quotas). The density of alive colonies of the false coral was, on average, six times lower in dived locations compared to controls, highlighting a clear impact of SCUBA diving (consistent over time). Colonies were also significantly smaller in dived locations. The diving quotas produced a significant reduction of the ratio dead/total colonies in the dived locations soon after their adoption, but these benefits disappeared over the following years, possibly due to a gradual decline in operators' and divers' observance and concern, rather than an increasing number of dives. This suggests that the adoption of effective regulations is crucial for the environmental sustainability of diving tourism in protected areas and can provide positive effects, but an effort is needed to ensure that compliance is consistent over time, and that low-impact diving practices are adopted by this important recreational sector.


Assuntos
Antozoários , Mergulho , Animais , Conservação dos Recursos Naturais , Ecossistema , Mar Mediterrâneo
5.
Diving Hyperb Med ; 51(4): 328-337, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34897597

RESUMO

INTRODUCTION: Inner ear barotrauma (IEBt) and inner ear decompression sickness (IEDCS) are the two dysbaric inner ear injuries associated with diving. Both conditions manifest as cochleovestibular symptoms, causing difficulties in differential diagnosis and possibly delaying (or leading to inappropriate) treatment. METHODS: This was a systematic review of IEBt and IEDCS cases aiming to define diving and clinical variables that help differentiate these conditions. The search strategy consisted of a preliminary search, followed by a systematic search covering three databases (PubMed, Medline, Scopus). Studies were included when published in English and adequately reporting one or more IEBt or IEDCS patients in diving. Concerns regarding missing and duplicate data were minimised by contacting original authors when necessary. RESULTS: In total, 25 studies with IEBt patients (n = 183) and 18 studies with IEDCS patients (n = 397) were included. Variables most useful in differentiating between IEBt and IEDCS were dive type (free diving versus scuba diving), dive gas (compressed air versus mixed gas), dive profile (mean depth 13 versus 43 metres of seawater), symptom onset (when descending versus when ascending or surfacing), distribution of cochleovestibular symptoms (vestibular versus cochlear) and absence or presence of other DCS symptoms. Symptoms of difficult middle ear equalisation or findings consistent with middle ear barotrauma could not be reliably assessed in this context, being insufficiently reported in the IEDCS literature. CONCLUSIONS: There are multiple useful variables to help distinguish IEBt from IEDCS. Symptoms of difficult middle ear equalisation or findings consistent with middle ear barotrauma require further study as means of distinguishing IEBt and IEDCS.


Assuntos
Barotrauma , Doença da Descompressão , Mergulho , Orelha Interna , Barotrauma/diagnóstico , Barotrauma/etiologia , Doença da Descompressão/diagnóstico , Doença da Descompressão/etiologia , Diagnóstico Diferencial , Mergulho/efeitos adversos , Humanos
6.
Diving Hyperb Med ; 51(4): 345-354, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34897599

RESUMO

INTRODUCTION: New Zealand (NZ) diving-related fatalities have been reported since the 1960s. The aim is to identify contributing risk factors, including medical, and to inform appropriate preventative strategies. METHODS: NZ scuba diving fatalities from 2007 to 2016 were searched from multiple sources - the National Coronial Information System (NCIS); the NZ Chief Coroner's office; Water Safety NZ Drownbase™ and the NZ Police National Dive Squad records. For inclusion, a victim must have been wearing a scuba set (which may include a rebreather). A key word search of the NCIS was made and the results matched to the other databases. An Excel® database was created and a chain of events analysis (CEA) conducted. RESULTS: Forty-eight scuba diving fatalities were identified, 40 men and eight women, average age 47 years (range 17-68), 20 of Maori ethnicity. Thirty-five were classified as overweight (14) or obese (21). Pre-existing medical risk factors were identified, either pre dive or at autopsy, in 37 divers, the commonest being ischaemic heart disease (IHD, 20), left ventricular hypertrophy (LVH, 18) and hypertension (seven). IHD, LVH and obesity were variously associated with each other. The likely commonest disabling conditions, identified in 32 cases, were asphyxia (15), cardiac (nine) and pulmonary barotrauma/cerebral arterial gas embolism (five). Multiple environmental and diving practice breaches and poor planning were identified in the CEA, similar to those seen in other studies. Thirty-eight divers had not released their weight belt. Information on resuscitation was limited. CONCLUSIONS: Obesity and cardiovascular disease were common and Maori appear to be over-represented, both as previously reported.


Assuntos
Mergulho , Adolescente , Adulto , Idoso , Autopsia , Causas de Morte , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Fatores de Risco , Adulto Jovem
7.
Diving Hyperb Med ; 51(4): 355-360, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34897600

RESUMO

INTRODUCTION: Recreational scuba diving has existed for over 70 years with organisations emerging that teach individuals with disabilities to dive. It is unclear what the physical and psychosocial effects of scuba interventions might be. This systematic review explores evidence for the effects of scuba diving in individuals with neurological disability, intellectual disability and autism. METHODS: The databases Medline, EMBASE, Ovid Emcare, and SportDiscus were searched. Included papers described a scuba-based intervention for clients with a neurological disability, intellectual disability and autism, with physical or psychosocial outcomes explored in the paper. Quality of the included papers was assessed using the McMaster Appraisal Tools, with descriptive data synthesis completed to explore the physical and psychosocial effects of the interventions. RESULTS: Four papers met the inclusion criteria: a cross-sectional investigation, a phenomenological study, a case-control study and a multiple case study. The quality of the papers was low to moderate. Papers addressed the psychosocial effects of scuba diving, including motivation to participate, participant experiences, the effect on cognition and physical self-concept. One study reported an increase in self-concept for the majority of participants. An increase in understanding instructions and in visual attention was reported in another. Enjoyment of the activity was reported and motivators to be involved in scuba diving for people with disabilities included fun and excitement. No papers addressed functional outcomes. CONCLUSIONS: Whilst scuba diving interventions appear to enhance physical self-concept and are enjoyable, conclusive evidence regarding effectiveness could not be determined. Research in this area is extremely limited.


Assuntos
Transtorno Autístico , Mergulho , Deficiência Intelectual , Estudos de Casos e Controles , Estudos Transversais , Humanos
8.
Diving Hyperb Med ; 51(4): 361-367, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34897601

RESUMO

INTRODUCTION: Divers are recommended to observe a pre-flight surface interval (PFSI) ≥ 24 hours before boarding a plane following a diving vacation. Decompression sickness (DCS) symptoms may occur during or post-flight. This study aimed to examine the adherence of PFSI ≥ 24 in vacationing divers, and if any perceived signs and symptoms of DCS during or after flight were experienced. METHODS: An anonymous online survey was publicised through diving exhibitions and social media. Data included diver/diving demographics, PFSI before flight, flight details, and perceived signs and symptoms of DCS during or after flight. RESULTS: Data from 316 divers were examined (31% female) with the age range 17-75 years (median 49). Divers recorded 4,356 dives in the week preceding the flight, range 1-36 (median 14). Overall, 251/316 (79%) respondents reported a PFSI of ≥ 24 hours. PFSIs of < 12 hours were reported by 6 respondents. Diagnosed and treated DCS developing during, and post flight was reported by 4 divers with PFSIs ≥ 24 hours and by 2 divers with PFSIs < 24 hours. Fifteen divers boarded a plane with perceived symptoms of DCS. CONCLUSIONS: These data suggest that most divers in this study observed the recommendations of a ≥ 24 hour PFSI with safe outcomes.


Assuntos
Medicina Aeroespacial , Doença da Descompressão , Mergulho , Adolescente , Adulto , Idoso , Doença da Descompressão/epidemiologia , Doença da Descompressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recreação , Inquéritos e Questionários , Adulto Jovem
9.
Diving Hyperb Med ; 51(4): 368-372, 2021 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-34897602

RESUMO

INTRODUCTION: Interpreting pulmonary function test (PFT) results requires a valid reference set and a cut-off differentiating pathological from physiological pulmonary function; the lower limit of normal (LLN). However, in diving medicine it is unclear whether an LLN of 2.5% (LLN-2.5) or 5% (LLN-5) in healthy subjects constitutes an appropriate cut-off. METHODS: All PFTs performed at the Royal Netherlands Navy Diving Medical Centre between 1 January 2015 and 1 January 2021 resulting in a forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and/or FEV1/FVC with a Z-score between -1.64 (LLN-5) and -1.96 (LLN-2.5) were included. Records were screened for additional tests, referral to a pulmonary specialist, results of radiological imaging, and fitness to dive. RESULTS: Analysis of 2,108 assessments in 814 subjects showed that 83 subjects, 74 men and nine women, mean age 32.4 (SD 8.2) years and height 182 (7.0) cm, had an FVC, FEV1 and/or FEV1/FVC with Z-scores between -1.64 and -1.96. Of these 83 subjects, 35 (42%) underwent additional tests, 77 (93%) were referred to a pulmonary specialist and 31 (37%) underwent high-resolution CT-imaging. Ten subjects (12%) were declared 'unfit to dive' for various reasons. Information from their medical history could have identified these individuals. CONCLUSIONS: Use of LLN-2.5 rather than LLN-5 for FEV1/FVC in asymptomatic individuals reduces additional investigations and referrals to a pulmonary specialist without missing important diagnoses, provided a thorough medical history is taken. Adoption of LLN-2.5 could save resources spent on diving medical assessments and protect subjects from harmful side effects associated with additional investigations, while maintaining an equal level of safety.


Assuntos
Mergulho , Adulto , Mergulho/efeitos adversos , Feminino , Humanos , Masculino , Testes de Função Respiratória , Estudos Retrospectivos , Espirometria , Capacidade Vital
13.
Int Marit Health ; 72(3): 223-227, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604993

RESUMO

Since the global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of a coronavirus disease 2019 (COVID-19) infection started, millions of people globally have become infected. It must not be forgotten that thousands of those affected are commercial or recreational divers. A severe COVID-19 seriously affects the respiratory system and the pulmonary parenchyma but it may also involve the cardiovascular and the blood coagulation system. For this reason, many divers and hyperbaric medicine specialists are becoming increasingly concerned about a diver's ability to safely return to diving after a SARS-CoV-2 infection. The article presents current guidelines for diving fitness health assessment after a COVID-19 both for active and prospective divers, with particular emphasis on the types of diagnostic procedures and tests to be performed in cases of asymptomatic infection with SARS-CoV-2 as well as in patients who have recovered from a symptomatic COVID-19.


Assuntos
COVID-19/complicações , Mergulho/normas , Retorno ao Trabalho , Guias como Assunto , Humanos , SARS-CoV-2
14.
Int Marit Health ; 72(3): 217-222, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604992

RESUMO

BACKGROUND: Divers thermal status influences susceptibility to decompression sickness hence the need for proper insulation during immersion in cold water. However, there is a lack of data on thermal protection provided by diving suits, hence this study. MATERIALS AND METHODS: Two different groups of divers wearing either a wetsuit (n = 15) or a dry suit (n = 15) volunteered for this study. Anthropometric data and dive experience were recorded; skin temperatures at the cervical-supraclavicular (C-SC) area and hands were assessed through high-resolution thermal infrared imaging taken pre- and post-dive. RESULTS: As far as anthropometrics, pre-dive C-SC temperatures (37.0 ± 0.4°C), depth (dry: 43 ± 4.6 mfw vs. wet: 40.3 ± 4.0 mfw) and water temperature exposure (4.3°C) are concerned, both groups were comparable. Total dive time was slightly longer for dry suit divers (39.6 ± 4.0 min vs. 36.5 ± 4.1 min, p = 0.049). Post-dive, C-SC temperature was increased in dry suit divers by 0.6 ± 0.6°C, and significantly decreased in wetsuit divers by 0.8 ± 0.6°C. The difference between groups was highly significant (dry: 37.5 ± 0.7°C vs. wet: 36.2 ± 0.7°C, p = 0.004). Hand's temperature decreased significantly in both groups (dry: 30.3 ± 1.2°C vs. wet: 29.8 ± 0.8°C, p = 0.33). Difference between groups was not significant. CONCLUSIONS: Medium-duration immersion in cold water (< 5°C), of healthy and fully protected subjects was well tolerated. It was demonstrated that proper insulation based on a three-layer strategy allows maintaining or even slightly improve thermal balance. However, from an operational point of view, skin extremities are not preserved.


Assuntos
Mergulho , Imersão , Temperatura Baixa , Humanos , Temperatura Cutânea , Temperatura , Água
15.
Artigo em Inglês | MEDLINE | ID: mdl-34682387

RESUMO

The long-term effects of diving on human lung function are controversially discussed. We investigated the lung function of traditional shellfish divers in southern Chile and identified risk factors for reduced lung volumes in divers. In a cross-sectional study, we assessed lung function in traditional shellfish divers and fishermen from two fishing communities. Male divers and fishermen aged 18-60 years were recruited. Participants' health and diving habits were assessed via standardized questionnaires. Descriptive statistics, chi-squared tests and multiple linear regression models were applied. Through door-to-door sampling, we recruited 112 divers and 63 fishermen (response 67%). Valid spirometries were obtained from 98 divers and 52 fishermen. Divers had higher values of forced vital capacity (FVC, Beta = 0.28, 95% confidence interval (CI): 0.09; 0.47) and forced expiratory volume in 1 s (FEV1, Beta = 0.23, 95%-CI: 0.07; 0.39) compared to fishermen. Among divers, lower values of FVC (Beta = -0.35, 95%-CI: -0.65; -0.05) were found in those with a high diving frequency, while diving depth was associated with higher values of FVC (Beta = 0.28, 95%-CI = 0.04; 0.52). Professional divers had better lung function compared to fishermen. However, among divers, lung function decreased with cumulative diving exposure, warranting approval in future studies to ensure the safety and health of divers.


Assuntos
Mergulho , Chile , Estudos Transversais , Humanos , Pulmão , Masculino , Frutos do Mar , Capacidade Vital
16.
J Exp Biol ; 224(19)2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34533564

RESUMO

Star-nosed moles (Condylura cristata) have an impressive diving performance and burrowing lifestyle, yet no ventilatory data are available for this or any other talpid mole species. We predicted that, like many other semi-aquatic and fossorial small mammals, star-nosed moles would exhibit: (i) a blunted (i.e. delayed or reduced) hypoxic ventilatory response, (ii) a reduced metabolic rate and (iii) a lowered body temperature (Tb) in hypoxia. We thus non-invasively measured these variables from wild-caught star-nosed moles exposed to normoxia (21% O2) or acute graded hypoxia (21-6% O2). Surprisingly, star-nosed moles did not exhibit a blunted HVR or decreased Tb in hypoxia, and only manifested a significant, albeit small (<8%), depression of metabolic rate at 6% O2 relative to normoxic controls. Unlike small rodents inhabiting similar niches, star-nosed moles are thus intolerant to hypoxia, which may reflect an evolutionary trade-off favouring the extreme sensory biology of this unusual insectivore.


Assuntos
Mergulho , Toupeiras , Animais , Temperatura Corporal , Hipóxia
18.
Diving Hyperb Med ; 51(3): 264-270, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34547777

RESUMO

INTRODUCTION: The aim of this study was to describe the nature of regular medications taken by active comorbid scuba divers (having a declared medical comorbidity) and scuba divers and snorkellers who died following a diving incident. METHODS: We undertook a retrospective, observational study from July to October, 2020. Data on 268 active comorbid divers were obtained through a 2013 survey of Divers Alert Network Asia-Pacific members. Data on 126 deceased scuba divers and 175 deceased snorkellers were obtained predominantly from 2001-2013 reports to Australian State Coronial Services. RESULTS: The active comorbid divers were significantly older, less likely to be male, and more likely to be taking one or more medications than the two deceased subject groups (P < 0.001). Cardiovascular, endocrine and psychotropic medications accounted for 53.4%, 9.9% and 6.4% of all medications taken, respectively. Almost one tenth of the deceased divers took at least one psychotropic medication, a proportion significantly greater than the other groups (P = 0.01). CONCLUSIONS: Medication use among active comorbid divers is common which likely reflects their declared medical condition. Nevertheless, they appear to be diving relatively safely, often with conditions once thought to be absolute contradictions to scuba diving. The deceased divers took significantly more psychotropic medications. It is possible that their underlying psychological/psychiatric conditions rendered them more at risk of a diving incident. Increased vigilance for psychological conditions may need to be considered during diving medical examinations.


Assuntos
Mergulho , Afogamento , Austrália/epidemiologia , Causas de Morte , Afogamento/epidemiologia , Humanos , Masculino , Estudos Retrospectivos
19.
Diving Hyperb Med ; 51(3): 295-298, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34547781

RESUMO

Heat loss is a major health hazard for divers. It can lead to hypothermia, organ damage, unconsciousness, and eventually death. Hence, thermal protection is essential for diver safety. Typically, protection is provided by wetsuits made of bubbled neoprene. However, neoprene shrinks with depth and loses thermal insulation capability, while thick neoprene suits make swimming exhausting. Herein, a proof-of-concept is presented for a solution to both problems: a 'K-suit' made of thermally-resistive composite segments attached to a thin neoprene suit. The segments are made of hollow glass microspheres embedded in carrier polymer thermally cured in 3D-printed molds based on 3D-scans of the diver's body. The K-suit was compared in field trials with a 7 mm commercial neoprene suit by diving in pairs, while automated dataloggers registered pressure and temperature inside and outside both suits. The K-suit demonstrated +4ºC higher temperature difference than the 7 mm neoprene. Also, divers reported that the K-suit had the ergonomics of a 3 mm neoprene suit. These preliminary results represent a proof-of-concept for the K-suit and promise further improvements with potential impact on diver safety.


Assuntos
Mergulho , Temperatura Corporal , Regulação da Temperatura Corporal , Humanos , Neopreno , Temperatura
20.
Diving Hyperb Med ; 51(3): 299-302, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34547782

RESUMO

INTRODUCTION: The aim of reporting these two cases is to present visual evidence by bronchoscopy of the origin of haemoptysis in two elite breath-hold divers. CASE REPORTS: Two male elite breath-hold divers of similar physical characteristics presented to our clinic after performing dives of up to 75 and 59 meters of seawater depth for 2:30 and 2:35 (minutes:seconds) respectively. Both patients presented with haemoptysis. Lung ultrasound was performed. The first patient had crackles on chest auscultation, overt pulmonary oedema clinically and 90 ultrasound lung comets. The second patient had no oedema or crackles, but presented with 20 ultrasound lung comets. Video bronchoscopy was performed which showed traces of blood coming from all three segments of the right upper lobe in both patients. The rest of the airways and lungs were intact. CONCLUSIONS: These finding suggest that the apical parts of the lungs are the most prone to deep-dive induced damage. The precise mechanism of lung barotrauma and haemoptysis in breath-hold divers remains to be elucidated. These findings may be of importance for a better understanding of the underlying pathology of haemoptysis.


Assuntos
Mergulho , Edema Pulmonar , Suspensão da Respiração , Mergulho/efeitos adversos , Hemoptise/etiologia , Humanos , Pulmão , Masculino , Edema Pulmonar/diagnóstico por imagem , Edema Pulmonar/etiologia , Ultrassonografia
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