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

Area of Science:

• Physiology
• Hyperbaric Medicine
• Diving Science

Background:

• Scuba diving involves ascent from hyperbaric conditions, posing a risk of inert gas accumulation and subsequent venous gas emboli (VGE) formation.
• Understanding decompression bubbles is crucial for diver safety across various diving disciplines.

Purpose of the Study:

• To conduct a scoping review of research on decompression bubbles in humans following hyperbaric exposures.
• To address the types of decompression exposures studied, methods for VGE assessment, and factors influencing bubble formation in scuba divers.

Main Methods:

• A comprehensive literature search identified 172 papers involving 6271 divers.
• Venous gas emboli (VGE) were assessed using 2D echocardiography and Doppler methods.
• Studies included recreational, technical, saturation, and occupational diving, with and without altitude exposure.

Main Results:

• The review analyzed publication characteristics, VGE methodologies, and decompression exposures.
• Bubble outcomes were categorized into physiological consequences, risk factors, and preventative strategies.
• Significant heterogeneity was observed in study designs, decompression profiles, ultrasound techniques, and bubble quantification.

Conclusions:

• The current research on decompression bubbles in divers exhibits considerable heterogeneity.
• Future research should prioritize developing comparative scales for decompression exposures, standardizing ultrasound methods, and investigating individual factors for personalized risk mitigation.
• Increased research focus on female divers is also recommended.