Preventive effect of pre-dive hydration on bubble formation in divers
Preventive effect of pre-dive hydration on bubble formation in divers
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DOI：
10.1136/bjsm.2007.043240
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发表时间：
2009-03-01
影响因子：
18.4
通讯作者：
Louge, P.
中科院分区：
文献类型：
--
作者：
Gempp, E.;Blatteau, J. E.;Louge, P.
目的：探讨潜水前90分钟预补水是否能减少气泡的形成，并评价由此对血浆体积（PV）、水平衡和血浆表面张力（ST）的调节。方法：8名军事潜水员参加了一项交叉试验，使用盐糖饮料进行潜水前补水（方案1），对照潜水不进行补水（方案2）。饮量1300 ml（渗透压324 mOsm/l），饮时间50 ~ 60 min。潜水方案包括在30毫西瓦深度的公海现场空中潜水30分钟，然后在3毫西瓦深度停留9分钟。血液动力学参数、体重测量、尿量和血液样本在摄入液体前后和潜水后采集。用心前脉冲多普勒检查减压气泡。结果：方案1的气泡活性明显低于方案2。摄入液体后PV增加3.5%，并在潜水方案1后恢复到基线水平，而在潜水方案2后下降2.2%。两种情况下潜水后PV的差异非常显著。在两个方案中，潜水前/潜水后的体重下降和潜水后的尿量都很显著，但方案1的体重相对下降仍然低于方案2，由于较高的液体潴留，负水平衡减少。两种方案在液体摄入和潜水后的ST没有差异。结论：潜水前口服水合液可减少循环气泡，从而提供了一种相对简单的降低减压病风险的方法。预水化条件可以减少脱水，防止潜水引起的低血容量血症。在本研究中，水合作用和潜水没有改变血浆表面张力。
Objective: To investigate whether prehydration 90 min before a dive could decrease bubble formation, and to evaluate the consequent adjustments in plasma volume (PV), water balance and plasma surface tension (ST).Methods: Eight military divers participated in a crossover trial of pre-dive hydration using saline-glucose beverage (protocol 1) and a control dive with no prehydration (protocol 2). Drink volume was 1300 ml (osmolality 324 mOsm/l) and drinking time was 50-60 min. The diving protocol consisted of an open sea field air dive at 30 msw depth for 30 min followed by a 9 min stop at 3 msw. Haemodynamic parameters, body weight measurements, urine volume and blood samples were taken before/after fluid intake and after the dive. Decompression bubbles were examined by a precordial pulsed Doppler.Results: Bubble activity was significantly lower for protocol 1 than for protocol 2. PV increased after fluid ingestion by 3.5% and returned toward baseline after diving for protocol 1, whereas it decreased by 2.2% after diving for protocol 2. Differences in post-dive PV between the two conditions were highly significant. Body weight loss before/after diving and post-dive urine volume after diving were significant in both protocols, but the relative decline in weight remained lower for protocol 1 than for protocol 2, with reduction of negative water balance due to higher fluid retention. There were no differences in ST after fluid intake and after diving for the two protocols.Conclusion: Pre-dive oral hydration decreases circulatory bubbles, thus offering a relatively easy means of reducing decompression sickness risk. The prehydration condition allowed attenuation of dehydration and prevention of hypovolaemia induced by the diving session. Hydration and diving did not change plasma surface tension in this study.