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Int J Sports Med 2019; 40(01): 31-37
DOI: 10.1055/a-0777-2279
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© Georg Thieme Verlag KG Stuttgart · New York

Bubble Formation in Children and Adolescents after Two Standardised Shallow Dives

Lisa Geyer
1   German Sport University, Institute of Movement and Neurosciences, Cologne, Germany
,
Konrad Brockmeier
2   Peadiatric Cardiology, University of Cologne, Cologne, Germany
,
Christine Graf
1   German Sport University, Institute of Movement and Neurosciences, Cologne, Germany
,
Benno Kretzschmar
3   Department of Paediatrics, St. Georg Hospital Eisenach, Eisenach, Germany
,
Karl-Heinz Schmitz
4   Cardiologist, Private Practice, Dinslaken, Germany
,
Ferdinand Webering
5   German Sport University, Institute of Cardiology and Sports Medicine, Cologne, Germany
,
Uwe Hoffmann
6   German Sport University, Institute of Physiology and Anatomy, Cologne, Germany
› Author Affiliations
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Publication History



accepted 22 October 2018

Publication Date:
20 November 2018 (online)

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Abstract

Circulating venous bubbles after dives are associated with symptoms of decompression sickness in adults. Up to now it is not known to what extent children and adolescents are subjected to a bubble formation during their shallow dives and if there are possible indications for that. The aim of this pilot study is to investigate whether bubbles and/or symptoms occur after standardised repeated dives performed by young divers. 28 children and adolescents (13.5±1.1 years) carried out two 25 min dives to a depth of 10 m with a 90 min surface interval. Before and after, echocardiographic data were recorded and evaluated with regard to circulating bubbles with an extended Eftedal-Brubakk-Scale by 2 different examiners. Bubbles were observed for a total of 6 subjects, Grade I (n=5) and Grade III (n=1). None of them showed any symptoms of decompression sickness. No differences were established regarding potential influencing factors on bubble formation between the groups with and without bubbles. The results indicate that even relatively shallow and short dives can generate venous bubbles in children and adolescents. To what extent this relates to the decompression sickness or clinical symptoms cannot be validated at this point.

Key words

circulating venous bubbles - echocardiography - repeated dives - bubble formation - children and adolescents - decompression sickness
 

  • References

  • 1 Bühlmann AA. Dekompressionstabellen. In: Bühlmann AA, Völlm EB, Nussberger P. (eds) Tauchmedizin. Berlin: Springer; 2002: 161-178
    CrossrefGoogle Scholar
  • 2 Bühlmann AA. Inertgasaufnahme und -abgabe des menschlichen Körpers. In: Bühlmann AA, Völlm EB, Nussberger P. (eds) Tauchmedizin. Berlin: Springer; 2002: 85-109
    CrossrefGoogle Scholar
  • 3 Bühlmann AA. Theoretische toleranzgrenzen und experimentelle ergebnisse. In: Bühlmann AA, Völlm EB, Nussberger P. (eds) Tauchmedizin. Berlin: Springer; 2002: 133-160
    CrossrefGoogle Scholar
  • 4 Carturan D, Boussuges A, Burnet H, Fondarai J, Vanuxem P, Gardette B. Circulating venous bubbles in recreational diving: Relationships with age, weight, maximal oxygen uptake and body fat percentage. Int J Sports Med 1999; 20: 410-414
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Carturan D, Boussuges A, Vanuxem P, Bar-Hen A, Burnet H, Gardette B. Ascent rate, age, maximal oxygen uptake, adiposity, and circulating venous bubbles after diving. J Appl Physiol 2002; 93: 1349-1356
    CrossrefPubMedGoogle Scholar
  • 6 Cialoni D, Pieri M, Balestra C, Marroni A. dive risk factors, gas bubble formation, and decompression illness in recreational scuba diving: Analysis of dan europe dsl data base. Front Psychol 2017; 8: 1587
    CrossrefPubMedGoogle Scholar
  • 7 Davis M. Decompression sickness in a 14-year-old diver. SPUMS J 2003; 33: 75-76
    PubMedGoogle Scholar
  • 8 Doolette DJ. Venous gas emboli detected by 2-dimensional echocardiography are an imperfect surrogate endpoint for decompression sickness. Diving Hyperb Med 2016; 46: 4-10
    PubMedGoogle Scholar
  • 9 Dunford RG, Vann RD, Gerth WA, Pieper CF, Huggins K, Wacholtz C, Bennett PB. The incidence of venous gas emboli in recreational diving. Undersea Hyperb Med 2002; 29: 247-259
    PubMedGoogle Scholar
  • 10 Eckenhoff RG, Olstad CS, Carrod G. Human dose-response relationship for decompression and endogenous bubble formation. J Appl Physiol 1990; 69: 914-918
    CrossrefPubMedGoogle Scholar
  • 11 Eftedal OS, Lydersen S, Brubakk AO. The relationship between venous gas bubbles and adverse effects of decompression after air dives. Undersea Hyperb Med 2007; 34: 99-105
    PubMedGoogle Scholar
  • 12 Gardette B. Correlation between decompression sickness and circulating bubbles in 232 divers. Undersea Biomed Res 1979; 6: 99-107
    PubMedGoogle Scholar
  • 13 Gawthrope IC, Summers M, Macey DJ, Playford DA. An observation of venous gas emboli in divers and susceptibility to decompression sickness. Diving Hyperb Med 2015; 45: 25-29
    PubMedGoogle Scholar
  • 14 Graf C, Dordel S. Das CHILT-I-Projekt (Children's Health InterventionaL Trial). Eine multimodale maßnahme zur prävention von bewegungsmangel und übergewicht an grundschulen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2011; 54: 313-321
    CrossrefPubMedGoogle Scholar
  • 15 Harriss D, Macsween A, Atkinson G. Standards for ethics in sport and exercise science research: 2018 Update. Int J Sports Med 2017; 38: 1126-1131
    Article in Thieme ConnectPubMedGoogle Scholar
  • 16 Lemaître F, Carturan D, Tourney-Chollet C, Gardette B. Circulating venous bubbles in children after diving. Pediatr Exerc Sci 2009; 21: 77-85
    PubMedGoogle Scholar
  • 17 Liou K, Wolfers D, Turner R, Bennett M, Allan R, Jepson N, Cranney G. Patent foramen ovale influences the presentation of decompression illness in SCUBA divers. Heart Lung Circ 2015; 24: 26-31
    CrossrefPubMedGoogle Scholar
  • 18 Ljubkovic M, Dujic Z, Møllerløkken A, Bakovic D, Obad A, Breskovic T, Brubakk AO. Venous and arterial bubbles at rest after no-decompression air dives. Med Sci Sports Exerc 2011; 43: 990-995
    CrossrefPubMedGoogle Scholar
  • 19 Ljubkovic M, Zanchi J, Breskovic T, Marinovic J, Lojpur M, Dujic Z. Determinants of arterial gas embolism after scuba diving. J Appl Physiol 2012; 112: 91-95
    Google Scholar
  • 20 Møllerløkken A, Blogg SL, Doolette DJ, Nishi RY, Pollock NW. Consensus guidelines for the use of ultrasound for diving research. Diving Hyperb Med 2016; 46: 26-32
    PubMedGoogle Scholar
  • 21 Nishi RY, Brubakk AO, Eftedal OS. Bubble detection. In: Brubakk AO, Neuman TS. (eds) Bennett and Elliott's Physiology and Medicine of Diving. Edinburgh: Saunders; 2003: 501-529
    Google Scholar
  • 22 Tsung JW, Chou KJ, Martinez C, Tyrrell J, Touger M. An adolescent scuba diver with 2 episodes of diving-related injuries requiring hyperbaric oxygen recompression therapy: A case report with medical considerations for child and adolescent scuba divers. Pediatr Emerg Care 2005; 21: 681-686
    CrossrefPubMedGoogle Scholar
  • 23 Verband Deutscher Sporttaucher eV. Sicherheitsstandards für die Ausübung des Tauchsports. Available from https://www.vdst.de/fileadmin/_migrated/content_uploads/VDST-Sicherheitsstandards_2012.pdf cited 21.11.2017
    PubMed
  • 24 Vik A, Brubakk AO, Hennessy TR, Jenssen BM, Ekker M, Slørdahl SA. Venous air embolism in swine: Transport of gas bubbles through the pulmonary circulation. J Appl Physiol 1990; 69: 237-244
    CrossrefPubMedGoogle Scholar
  • 25 Wenzel J, Ehm OF. Dekompression. In: Ehm OF. (ed.) Tauchen Noch Sicherer. Stuttgart: Pietsch; 2012: 199-221
    Google Scholar