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1 Department of Physiology and Biophysics, University of Split School of Medicine, Split, Croatia (Hrvatska)
2 Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
* To whom correspondence should be addressed. E-mail: zdujic{at}bsb.mefst.hr.
Paradoxical arterializations of venous gas emboli can lead to neurological damage after diving with compressed air. Recently, significant exercise-induced intra-pulmonary anatomical shunts have been reported in healthy humans that result in widening of alveolar-to-arterial oxygen gradient. The aim of this study was to examine whether intra-pulmonary shunts can be found following strenuous exercise after diving, and, if so, whether exercise should be avoided during that period. Eleven healthy, military male divers performed an open-sea dive to 30 m breathing air, remaining at pressure for 30 minutes. During the bottom phase of the dive subjects performed mild exercise at about 30% of their maximal oxygen uptake. The ascent rate was 9 m/min. Each diver performed graded upright cycle ergometry up to 80% of the maximal oxygen uptake 40 min following the dive. Monitoring of venous gas emboli was performed in both the right and left heart with an ultrasonic scanner every 20 minutes for 60 minutes after reaching the surface pressure during supine rest and following 2 coughs. The diving profile used in this study produced significant amounts of venous bubbles. No evidence of intra-pulmonary shunting was found in any subject either during supine resting posture or during any exercise grade. Also, short strenuous exercise after the dive did not result in delayed-onset decompression sickness in any subject, but the studies with greater number of participants are needed to confirm whether divers should be allowed to exercise following diving.
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