Saturation Diving; Physiology and Pathophysiology
Saturation Diving; Physiology and Pathophysiology
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DOI：
10.1002/cphy.c130048
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发表时间：
2014-07-01
影响因子：
5.8
通讯作者：
Thom, Stephen R.
中科院分区：
文献类型：
--
作者：
Brubakk, Alf O.;Ross, John A. S.;Thom, Stephen R.
在饱和潜水中，潜水员保持在压力下，直到他们的大部分组织都充满了呼吸气体。潜水员长时间处于隔离状态，暴露于氧分压增加、潜在有毒气体、细菌和减压期间气泡形成，加上轮班工作和长时间相对不活动。高氧可导致产生与细胞结构相互作用的活性氧（ROS），从而导致蛋白质、脂质和核酸的损伤。血管气泡形成和高氧可导致内皮功能障碍。潜水员体内的抗氧化系统是其抗损伤的重要机制，受饮食和遗传因素的影响，这些因素可能导致热休克蛋白（HSP）的产生，进而影响内皮细胞的功能。另一方面，有大量证据表明热休克蛋白也可能具有“调节”作用，从而保护免受伤害。随着年龄的增长，他们产生抗氧化剂的能力下降。我们目前还不知道抗氧化防御的能力，但可以合理地假设它有一个极限。许多研究已经将ROS与疾病状态如癌症、胰岛素抵抗、糖尿病、心血管疾病和动脉粥样硬化以及老年联系起来。然而，ROS也参与许多保护机制，例如免疫防御、抗菌作用、血管张力和信号转导。轻度的氧化应激会增加抗氧化剂的产生。当处于压力下时，潜水员会频繁地改变深度。在这种变化之后以及潜水结束时，潜水员必须遵循安全潜水的程序。减压病（DCS）曾是饱和潜水的主要致伤原因之一。减压程序的改进大大减少了报告的事故数量;然而，数据表明，受伤情况严重漏报。此外，需要迅速返回水面的潜水员受到严重伤害的风险更高，因为没有适当的减压程序可用于这种情况。减压还导致内皮微粒的产生，可能会降低内皮功能。由于良好的内皮功能是健康的一个有记录的指标，可以通过定期锻炼的影响，定期体育锻炼建议饱和潜水员。如今，饱和潜水是一个合理的安全和良好的控制方法在水下工作。到目前为止，还没有记录到潜水对健康的长期影响。然而，我们仍然有有限的知识有关的病理生理机制。特别是，我们对长期暴露于高氧和微粒对内皮细胞的影响知之甚少。(C)2014年美国生理学会。
In saturation diving, divers stay under pressure until most of their tissues are saturated with breathing gas. Divers spend a long time in isolation exposed to increased partial pressure of oxygen, potentially toxic gases, bacteria, and bubble formation during decompression combined with shift work and long periods of relative inactivity. Hyperoxia may lead to the production of reactive oxygen species (ROS) that interact with cell structures, causing damage to proteins, lipids, and nucleic acid. Vascular gas-bubble formation and hyperoxia may lead to dysfunction of the endothelium. The antioxidant status of the diver is an important mechanism in the protection against injury and is influenced both by diet and genetic factors.The factors mentioned above may lead to production of heat shock proteins (HSP) that also may have a negative effect on endothelial function. On the other hand, there is a great deal of evidence that HSPs may also have a "conditioning" effect, thus protecting against injury.As people age, their ability to produce antioxidants decreases. We do not currently know the capacity for antioxidant defense, but it is reasonable to assume that it has a limit. Many studies have linked ROS to disease states such as cancer, insulin resistance, diabetes mellitus, cardiovascular diseases, and atherosclerosis as well as to old age. However, ROS are also involved in a number of protective mechanisms, for instance immune defense, antibacterial action, vascular tone, and signal transduction. Low-grade oxidative stress can increase antioxidant production.While under pressure, divers change depth frequently. After such changes and at the end of the dive, divers must follow procedures to decompress safely. Decompression sickness (DCS) used to be one of the major causes of injury in saturation diving. Improved decompression procedures have significantly reduced the number of reported incidents; however, data indicate considerable underreporting of injuries. Furthermore, divers who are required to return to the surface quickly are under higher risk of serious injury as no adequate decompression procedures for such situations are available.Decompression also leads to the production of endothelial microparticles that may reduce endothelial function. As good endothelial function is a documented indicator of health that can be influenced by regular exercise, regular physical exercise is recommended for saturation divers.Nowadays, saturation diving is a reasonably safe and well controlled method for working under water. Until now, no long-term impact on health due to diving has been documented. However, we still have limited knowledge about the pathophysiologic mechanisms involved. In particular we know little about the effect of long exposure to hyperoxia and microparticles on the endothelium. (C) 2014 American Physiological Society.