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Ontogeny of total body oxygen stores and aerobic dive potential in Steller sea lions (Eumetopias jubatus).

Two key factors influence the diving and hence foraging ability of marine mammals: increased oxygen stores prolong aerobic metabolism and decreased metabolism slows rate of fuel consumption. In young animals, foraging ability may be physiologically limited due to low total body oxygen stores and high mass specific metabolic rates. To examine the development of dive physiology in Steller sea lions, total body oxygen stores were measured in animals from 1 to 29 months of age and used to estimate aerobic dive limit (ADL). Blood oxygen stores were determined by measuring hematocrit, hemoglobin, and plasma volume, while muscle oxygen stores were determined by measuring myoglobin concentration and total muscle mass. Around 2 years of age, juveniles attained mass specific total body oxygen stores that were similar to those of adult females; however, their estimated ADL remained less than that of adults, most likely due to their smaller size and higher mass specific metabolic rates. These findings indicate that juvenile Steller sea lion oxygen stores remain immature for more than a year, and therefore may constrain dive behavior during the transition to nutritional independence.

Age Factors↗

Continuous monitoring of haemodynamic parameters in humans during the early phase of simulated diving with and without breathholding.

This study examined the integrative changes of blood pressure (BP) and stroke volume (SV) leading to the initial biphasic heart rate (fc) response (first 15 s) in simulated diving manoeuvres with and without breathholding (BH). Simulated diving was studied in ten young healthy volunteers by application of a gel-filled pack at 0 degree C and 18 degrees C on the forehead with and without BH. Beat-by-beat and second-to-second fc, BP, SV, and total peripheral vascular resistance (TPR) were followed by continuous non-invasive monitoring. In all conditions (BH with forehead cooling at 0 degree and 18 degrees C) there was an early rise in BP triggering the first tachycardial response (fc acceleration) which was immediately counteracted by the concurrent further increase of SV leading to the second phase of early bradycardic response (fc deceleration). Furthermore, the continuous beat-by-beat and second-to-second monitoring allowed the documentation of a highly significant increase of TPR within the first few seconds of the manoeuvres. Our data further indicated that the differences in haemodynamics observed during the stimuli at different temperatures was overruled by BH. Detailed comparisons of the beat-by-beat and second-to-second analyses were unable to show that one method was better than the other. Using continuous non-invasive monitoring of haemodynamic variables during simulated diving manoeuvres it was possible to provide better insights into the physiological principles and meaning of the diving reflex in humans.

Adult↗

The source of circulating catecholamines in forced dived ducks.

Plasma catecholamines have been measured in chronically adrenalectomized (ADX) ducks, in chronically adrenal-denervated ducks (DNX), and in their respective shamoperated controls (SH-adx, SH-dnx) after 3 min forced submergence. The results showed that 100% of the plasma epinephrine (EP) and 70 to 80% of plasma norepinephrine (NE) released during the dive came from the adrenal glands. Only 20 to 30% of plasma NE came from the endings of the autonomic vascular sympathetic nerves which are strongly stimulated during diving. Adrenal catecholamines were released by nerve activation only; nonneural mechanisms did not play any role in their release. The action of adrenal catecholamines on the cardiovascular system during dives was investigated by measuring heart rate and arterial blood pressure in operated and sham-operated ducks. Cardiovascular adjustments, associated with 3 min of forced diving, were not affected by any differences in the levels of plasma catecholamines.

Adrenal Glands↗

Activation of the trigeminal medullary dorsal horn during voluntary diving in rats.

Fos immunohistochemistry was used to indicate whether activation of trigeminal neurons occurs in voluntarily diving rats. In rats trained to dive underwater, significant increases in Fos labeling were found within the ventral superficial MDH and paratrigeminal nucleus, 100-150 microm caudal to the obex compared to control rats. The conclusion is that the ventral superficial MDH is the initial brainstem afferent relay of diving response in voluntarily diving rats.

Animals↗

Breathing at depth: physiologic and clinical aspects of diving while breathing compressed gas.

When diving, human beings are exposed to hazards that are unique to the hyperbaric underwater environment and the physical behavior of gases at higher ambient pressure. Hypercapnia, hyperoxia, carbon monoxide intoxication, inert gas (predominantly nitrogen) narcosis, and decompression illness all may lead to impaired consciousness, with a high risk of drowning in this non-respirable environment. Proper physiologic function and adaptation of the respiratory system are of the utmost importance to minimize the risks associated with compressed gas diving. This article provides an introduction to the diving techniques, the physics, and the pertinent human physiology and pathophysiology associated with this extreme environment. The causes of the major medical problems encountered in diving are described, with an emphasis on the underlying respiratory physiology.

Barotrauma↗

Effects of breath-hold diving on bone mineral density of women divers.

OBJECTIVES: The relationship between bone mineral density (BMD) and swimming has been thoroughly researched. The aim of this study was to determine the effects of breath-hold diving on the BMD in the proximal femurs of women divers. METHODS: A case-control observational study was carried out using health-checks of divers and control subjects at a hospital in Jeju City, South Korea. Women divers (N=61) were matched individually with non-diver controls (N=61) by age, weight, and postmenopausal year. The bone mineral densities of their proximal femurs (total hip, femoral neck) were assessed by dual-energy X-ray absorptiometry. RESULTS: The average diving year of women divers was 34+/-13 years. The BMD of divers was higher than that of controls in the total hip and femur neck area (P<0.05). On multiple linear regression analysis, age and body weight were predictors of proximal femur bone mineral densities in divers. On linear regression analysis of the proximal femur BMD according to age in divers and controls, the bone mineral densities of divers tend to decrease more rapidly than those of controls in all two areas of the proximal femurs. CONCLUSIONS: Our study results may suggest that diving in a high-pressure environment is an osteogenic stimulus. However, the weight-supported environment in diving exerts an effect that reduces BMD proportionately to the time spent in the water.

Absorptiometry, Photon↗

[Long-term effects of iterative diving on visual field, color vision and contrast sensitivity in professional divers].

PURPOSE: To assess long-term functional effects of iterative diving, we studied visual field, color vision, and contrast sensitivity in 21 French Navy professional divers and 21 controls. PATIENTS AND METHODS: This retrospective study investigated a population of 21 divers and 21 controls. All subjects were male. The inclusion criterion for divers was a total number of dives greater or equal to 1,000. Exclusion criteria for the two groups were glaucoma, ocular hypertension, smoking, and vasospastic risks. Additional exclusion criteria for controls were any history of diving practice and of hyperbaric oxygen therapy. The visual field was examined with a Humphrey Central 30-2 threshold test. Moreover, we explored spatial contrast sensitivity using Metrovision Moniteur Ophtalmologique "STAT" program and color vision with desaturated 15 hue test. RESULTS: None of the divers had any loss of spatial contrast sensitivity. There was a high frequency of yellow-blue axis color vision defects (45.2%) in the diver group. Regarding visual field, corrected pattern standard deviation was significantly higher in divers (p<0.01). CONCLUSION: These findings suggest that iterative diving may cause subclinical functional effects on vision. Further studies will be needed to determine the exact setting of this repercussion upon macula and/or the optic nerve.

Adult↗

Scuba diving-induced pulmonary edema in a swimming pool.

SCUBA diving-induced pulmonary edema is a rare syndrome that has been previously reported to occur in cold water. We present a case of SCUBA diving-induced pulmonary edema in a 52-year-old man diving in a warm swimming pool. The pathophysiology of this syndrome is unclear, but it is unrelated to either barotrauma or decompression illness. This patient developed frank pulmonary edema while submerged, which resolved after surfacing. As with other patients who have had this syndrome, he did not have any cardiorespiratory disease. The presentation and pathophysiology of SCUBA diving-induced pulmonary edema are discussed.

Diving↗

Intersexual differences in the diving behaviour of foraging subantarctic cormorant (Phalacrocorax albiventer) and Japanese cormorant (P. filamentosus).

Cormorants feed by feet-propelled diving. How cormorants optimize foraging is of a particular interest in relation to the understanding of the feeding strategies of diving birds, as well as within the debate about cormorants' impact on sustainable resources. Using microdata loggers that recorded diving depth, we investigated the foraging strategy of males and females of subantarctic cormorants, which inhabit cold regions, and of Japanese cormorants, which live in the northern temperate zone. For both species, males and females daily spent the same amount of time submerged, and apparently captured the same amount of fish. However, males dived deeper and longer, which could be explained by their 15-20% larger body mass and may minimize potential competition for food.

Animals↗

Diving seals, ischemia-reperfusion and oxygen radicals.

The cardiovascular adaptations of seals that contribute to their ability to tolerate long periods of diving asphyxial hypoxia result in episodic regional ischemia during diving and abrupt reperfusion upon termination of the dive. These conditions might be expected to result in production of oxygen-derived free radicals and other forms of highly reactive oxygen species. Seal organs vary during dives with respect to the degree and persistence of ischemia. Myocardial perfusion is reduced and intermittent; kidney circulation is vigorously vasoconstricted. Heart and kidney tissues from ringed seals (Phoca hispida) and domestic pigs (Sus scrofa) were compared in reactions to experimental ischemia. Resulting production of hypoxanthine, indicative of ATP degradation, was higher in pig than in seal tissues. Activity of superoxide dismutase (SOD), an oxygen radical scavenger, was higher in seal heart. We suggest that these results indicate enhanced protective cellular mechanisms in seals against the potential hazard of highly reactive oxygen forms. SOD activity was unexpectedly higher in pig kidney.

Animals↗

Technique and timing in the womens forward two and one half somersault pike and mens three and one half somersault pike 3m springboard dives.

The purpose of this study was to compare the forward two and one half somersault dive in a pike position (105B) performed by females (n=25) and the forward three and one half somersault dive in a pike position (107B) performed by males (n=25) to determine changes required by females to successfully perform 107B. Video data of the dives performed at the 1999 FINA World Diving Cup were captured and digitised to obtain times and postures of the divers at specific events including hurdle landing, takeoff, and entry. Estimates of hurdle flight height and mass-normalised work done on the springboard were obtained from hurdle and flight times. Females performing 105B had significantly less hip and knee flexion at landing from the hurdle than males performing 107B. It is known from simulations that the ability to land in a very flexed position without absorbing energy depends on the ability to generate large extension torques at landing. Therefore, it is likely that females need to increase strength to successfully complete 107B.

Adolescent↗

Vitamin C supplementation influences the antioxidant response and nitric oxide handling of erythrocytes and lymphocytes to diving apnea.

OBJECTIVE: We have investigated the influence of vitamin C diet supplementation on the antioxidant response and nitrite levels in lymphocytes and erythrocytes during diving apnea. SUBJECTS: Seven male professional apnea divers participated in a double blind crossover study. Divers were randomly assigned to either vitamin C supplemented or placebo groups. The subjects did not take any other supplements than the ones provided for this study. INTERVENTION: One group was supplemented with vitamin C capsules (1 g per day) for 7 days while the other group took a placebo composed of lactose. The usual dietary habits of participants were assessed using a self-reported 7-days 24-h recall before the day of the study. Blood samples were taken under basal conditions, immediately after diving apnea for 4 h and after 1 h of recovery. RESULTS: Catalase activity increased in erythrocytes (23%) and superoxide dismutase increased in lymphocytes (35%) during the recovery only in the placebo group. Lymphocyte ascorbate levels increased in the supplemented group after diving (85%) and maintained high at recovery. Plasma nitrite levels increased about twofold in both groups during the recovery. Erythrocyte nitrite levels increased after diving (50%) and about twofold during the recovery in the supplemented group. Nitrite levels and iNOS levels in lymphocytes were higher in the placebo group than in the supplemented during the recovery. Erythrocyte carbonyl derivates were unchanged in all situations. CONCLUSIONS: Vitamin C supplementation influenced the antioxidant response and NO handling in erythrocytes and lymphocytes to the oxidative stress induced by hypoxia-reoxygenation.

Antioxidants↗

What you need to know about diving medicine but won't find in a textbook.

The old adage that 'if a patient in your emergency department (ED) is wearing a wetsuit, fins and a mask, then he/she probably has a diving related illness' is one that should be remembered. This is an obvious statement that should not need stating; however, simple clues can be missed or disregarded. This article will address issues that may confront emergency physicians and for which there are few resources to find the answers. It aims to explain the reasons behind some of the advice given during consultation with a hyperbaric physician. The second aim is to bring emergency physicians up to date with new diving practices and how these may impact upon traditional diving injuries. To achieve these aims, this article is a compilation of answers to frequently asked or pertinent questions related to diving medicine.

Decompression Sickness↗

Diving medicine: contemporary topics and their controversies.

SCUBA diving is a popular recreational sport. Although serious injuries occur infrequently, when they do knowledge of diving medicine and/or where to obtain appropriate consultation is essential. The emergency physician is likely to be the first physician contact the injured diver has. We discuss 8 subjects in diving medicine which are contemporary, yet may have controversies associated with them. From this information the physician dealing primarily with the injured diver will have a basis for understanding and managing, as well as where to find additional help, for his/her patients' diving injuries.

Athletic Injuries↗

Problems associated with scuba diving are not evenly distributed across a menstrual cycle.

The problems encountered during scuba diving may be a contributing factor in an episode of decompression illness (DCI). Evidence exists that there may be a relationship between the position in the menstrual cycle and the occurrence of DCI. We examined, by prospective observation in female recreational scuba divers, any interaction between reported problems during diving (RPDD) and the position in the menstrual cycle. A total of 533 women, aged between 14 and 57 years, returned diaries for >6 months, with 61% returning diaries for 3 consecutive years. A total of 34,625 dives were reported within 11,461 menstrual cycles between 21 and 40 days in length, with 65% of women reporting at least one RPDD. Logistic regression showed a significant non-linear relationship between the position in the menstrual cycle and RPDD (p = 0.004). RPDD were not evenly distributed over the menstrual cycle; the rate per 1,000 dives varied from 39.2 at start of the cycle to 19.7 during week 3, and 31.9 in week 4. We concluded these field data suggest a possible correlation between the incidence of RPDD and the position in which they occurred in the menstrual cycle.

Adolescent↗

Orbital subperiosteal hemorrhage while scuba diving.

PURPOSE: To report an uncommon case of unilateral subperiosteal hemorrhage while scuba diving involving the orbit, a condition characterized by proptosis and associated severe ocular motility disturbances with displacement of the eyeball. MATERIAL AND METHODS: Observational case report. RESULTS: Unilateral subperiosteal hemorrhage in a 31-year-old woman while scuba diving at a depth of 20 meters. This was documented by clinical and radiographic examination. Computed tomography (CT) scan demonstrated a subperiosteal hemorrhage as a self-limited mass protruding into the left orbit. The process resolved without treatment and without visual or motility sequelae. A CT-scan, nuclear magnetic resonance, and conventional angiography did not show any venous abnormalities in the brain. CONCLUSION: During scuba diving at a depth of 20 meters, the pressure is three atmospheres, whereas within the diving mask the pressure is one atmosphere if it is not equilibrated; thus, a negative pressure is created within the mask. Small vessels can be broken in the conjunctiva or subperiosteal space by this force. It is important to exclude vascular abnormalities, especially if there is a positive family history.

Adult↗

Energetic cost of foraging in free-diving emperor penguins.

Hypothesizing that emperor penguins (Aptenodytes forsteri) would have higher daily energy expenditures when foraging for their food than when being hand-fed and that the increased expenditure could represent their foraging cost, we measured field metabolic rates (FMR; using doubly labeled water) over 4-d periods when 10 penguins either foraged under sea ice or were not allowed to dive but were fed fish by hand. Surprisingly, penguins did not have higher rates of energy expenditure when they dove and captured their own food than when they did not forage but were given food. Analysis of time-activity and energy budgets indicated that FMR was about 1.7 x BMR (basal metabolic rate) during the 12 h d(-1) that penguins were lying on sea ice. During the remaining 12 h d(-1), which we termed their "foraging period" of the day, the birds were alert and active (standing, preening, walking, and either free diving or being hand-fed), and their FMR was about 4.1 x BMR. This is the lowest cost of foraging estimated to date among the eight penguin species studied. The calculated aerobic diving limit (ADL(C)), determined with the foraging period metabolic rate of 4.1 x BMR and known O(2) stores, was only 2.6 min, which is far less than the 6-min ADL previously measured with postdive lactate analyses in emperors diving under similar conditions. This indicates that calculating ADL(C) from an at-sea or foraging-period metabolic rate in penguins is not appropriate. The relatively low foraging cost for emperor penguins contributes to their relatively low total daily FMR (2.9 x BMR). The allometric relationship for FMR in eight penguin species, including the smallest and largest living representatives, is kJ d(-1)=1,185 kg(0.705).

Animals↗

Blood volume and diving ability of the New Zealand sea lion, Phocarctos hookeri.

We test the hypothesis that the New Zealand sea lion is physiologically better equipped for prolonged, continuous diving than other otariids (fur seals and sea lions) by measuring its blood volume, an important component of its oxygen storage. Mass, hematocrit, and plasma volume were measured and blood volume calculations were completed on 14 adult females and five juvenile females. Plasma volume was determined using the Evans blue dye dilution technique. Mean plasma volume for all subjects was 74 mL kg(-1). Mass-specific plasma volume was significantly higher in adult females (15.3%) than in juveniles (14.6%). Blood volume (150 mL kg(-1)) and hematocrit (51%) were not significantly different between adults and juveniles. The aerobic dive limit can be estimated by dividing the animal's oxygen stores by its metabolic rate. The estimated aerobic dive limit for adult animals was between 5.5 and 7.8 min, depending on the assumed metabolic rate. New Zealand sea lions have the highest blood volume yet reported for an otariid, which supports the hypothesis that they have a physiological capability suited to their unique diving behavior.

Aerobiosis↗