Post-dive decompression bubbles in scuba divers: A scoping review

Scuba diving can cause venous gas emboli (VGE) formation upon ascent, due to inert gas accumulation in tissues. This scoping review examines the breadth of research on decompression bubbles in humans following hyperbaric exposures. The study aimed to address three research questions: 1) What decompres-sion exposures have been used to record bubble data in scuba divers? 2) How are post-decompression VGE assessed and graded? 3) What factors influence post-decompression bubble formation in scuba divers, and what is their impact? We identified 172 papers, involving 6271 divers, examined for VGE using 2D echocardiography and Doppler methods following recreational, technical, saturation, and occupational decompression exposures, with or without altitude exposure during or after diving. Publication characteristics, VGE methodologies, and decompression exposures are discussed, while bubble outcomes were broadly classified into three groups: physiological consequences of bubbles, risk factors of bubble formation, and preventative strategies for reducing bubble formation. This review presents the scope of research focused on decompression bubbles in humans and highlights the heterogeneity in study designs, decompression exposures, ultrasound methodologies, bubble quantification, and overall findings. Future research should focus on developing a comparative scale for decompression exposures, standardized ultrasound methods, increased research on female divers, and investigating the interaction of individual factors with dive profiles to enhance individualized approaches to mitigating decompression bubble risks.