Predicting time to decompression illness during exercise at altitude, based on formation and growth of bubbles

For altitude decompressions, we hypothesized that reported onset times of limb decompression illness (DCI) pain symptoms follow a probability distribution related to total bubble volume [V(b.)(t)] as a function of time. Furthermore, we hypothesized that the probability of ever experiencing DCI during a decompression is associated with the cumulative volume of bubbles formed. To test these hypotheses, we first used our previously developed formation-and-growth model (Am J Physiol Regulatory Integrative Comp Physiol 279: R2304-R2316, 2000) to simulate Vb.(t) for 20 decompression profiles in which 334 human subjects performed moderate repetitive skeletal muscle exercise (827 kJ/h) in an altitude chamber. Using survival analysis, we determined that, for a controlled condition of exercise, the fraction of the subject population susceptible to DCI can be approximately expressed as a power function of the formation-and-growth model-predicted cumulative volume of bubbles throughout the altitude exposure. Furthermore, for this fraction, the probability density distribution of DCI onset times is approximately equal to the ratio of the time course of formation-and growth-modeled total bubble volume to the predicted cumulative volume.