Related Experiment Video
Updated: Oct 25, 2026

Hypercapnic Hyperventilation to Accelerate Emergence from Inhaled Volatile Anesthetics: A Practical Method Using Standard Hospital Equipment
Published on: June 26, 2026
Principles, concepts, and perspectives for the improvement of decompression procedures: a Neo-Haldanian approach
Jean-Pierre Imbert1, Ran Arieli2,3, Costantino Balestra1,4,5
1Environmental and Occupational, Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), Brussels, Belgium.
Introduction:
This paper is a narrative review and theoretical perspective presenting principles, concepts, and perspectives for improving decompression procedures. It distinguishes three levels of evidence: established observations, hypotheses with experimental support, and mechanistic scenarios that remain hypothetical.
Methods:
We organize decompression around two linked dimensions: bubbles as the primary physical event and microparticles (MPs) as a physiological consequence. We hypothesize that a substantial proportion of decompression-related microbubbles originate from pre-existing gas micronuclei associated with active hydrophobic sites (AHS) at three locations: distal arterial, venous, and extravascular. From these assumptions, five bubble scenarios are considered: growth and detachment from distal arterial AHS; growth and detachment from venous AHS; pulmonary bubble filtration; survival of arterial gas microbubbles and their potential target organs; and intravascular bubble development. Physiological factors may generate MPs, endothelial dysfunction, systemic inflammation, and possibly a secondary generation of microbubbles.
Results And Discussion:
The proposed scenarios align with decompression sickness (DCS) pathophysiology across five target organ systems: skin, brain, inner ear, spinal cord, and musculoskeletal tissue. Inflammatory stress appears important for defining post-dive intervals and multiday diving patterns. Designing decompression procedures therefore requires integrating individual variability and dive history; dive characteristics such as rapid ascents, yo-yo diving, and surface decompression; the bubble scenarios triggered during ascent; and accumulated oxidative stress, oxy-inflammation, and endothelial damage that modify susceptibility to DCS.
Conclusion:
There is no single ultimate decompression algorithm; rather, different strategies reflect different experience, assumptions, and operational contexts.
Related Concept Videos
Physical Principles Governing Gas Exchange
Gas Laws Governing Respiration
The behavior of gases is guided by Dalton's Law of partial pressures and Henry's Law.
Dalton's Law asserts that the total pressure exerted by...
Excess Pressure Inside a Drop and a Bubble
Physiological Control of Respiration
Breathing, a seemingly passive process, is regulated by the respiratory center in the brainstem. This center coordinates the involuntary control of respirations, which means it occurs without conscious effort, ensuring a smooth and uninterrupted pattern.
Regulation of Ventilation
The body maintains ventilation by monitoring levels of carbon dioxide (CO2), oxygen (O2), and hydrogen ion concentration (pH) in the arterial blood. Among these factors, the level of CO2 plays a crucial...
Pneumothorax II: Pathophysiology
Pressure Relationships in Thoracic Cavity
Breathing Mechanisms
Both intra-alveolar and intrapleural pressures rely on specific lung properties. The ability to breathe—allowing air to enter the lungs during...
Cardiopulmonary Resuscitation II: ACLS Airway Management
