Blatteau - Revision history

M.bennett at 03:42, 2 July 2019

2019-07-02T03:42:10Z

M.bennett at 03:40, 2 July 2019

2019-07-02T03:40:46Z

M.bennett at 03:36, 2 July 2019

2019-07-02T03:36:48Z

Gordoben: Imported from Wikispaces

2018-11-26T05:37:12Z

Imported from Wikispaces

New page

'''Pre-compression exercise decreased bubble counts following compressed air breathing '''
{|
| '''Clinical Bottom Line''' 1. Pre-'dive' exercise reduces bubble grade after diving.
|-
|}
'''Citation/s:'''1. Blatteau J-E, Boussuges A, Castagna, Gempp E, Pontier J-N, Robinet OC, Galland F-M. A 2-hours pre-dive aerobic exercise decreases bubble formation after diving. ICHM-EUBS Proceedings 2005, Desola J (Ed).Barcelona7-10 September 2005.

'''Three-part Clinical Question:''' For individuals breathing compressed air, does exercise before exposure decrease post-exposure bubble formation?
'''Search Terms:''' gas nuclei, decompression illness, venous gas embolism

'''The Study:'''Non-blinded randomised crossover trial with intention-to-treat.
'''The Study Patients:''' Healthy volunteer military divers.
'''Control group''' (Two groups of N = 16; 16 analysed): No exercise or diving for two days before exposure to 400kPa (approx 30metres) for 30 minutes breathing air in a hyperbaric chamber.
'''Experimental group''' (Two groups of N = 16; 16 analysed): As above but two exercise regimens. Either 45 minutes of endurance running at about 70% of maximum theoretical heart rate starting 2 hours before exposure, or 40 minutes at the heart rate corresponding to ventilatory threshold.

'''The Evidence:'''

{|
| '''Non-Event Outcomes''' || '''Time to outcome/s''' || '''Control groups''' || '''Exercise groups''' || '''P-value''' 
|-
| '''Peak bubble grade (45 minutes exercise)''' || 60 minutes || Median 1 (IQR 0 to 2) || Median 0 (IQR 0 to 1) || 0.004
|-
| '''Peak bubble grade (40 minutes exercise)''' || 60 minutes || || || 0.023
|-
|}
'''Comments:'''
1. Confusing study design involving crossover and two different exercise regimens. We have assumed that no individuals were crossed between the two exercise regimens. Difference in exercise intensity is not clear.
2. Data given for 45 minute group comparison only.
3. Non-peer reviewed short report in conference proceedings.

'''Appraised by''': Sean Hopson, Mike Bennett, POWH, Sydney ; Friday, 1 September 2006Email: [[mailto:sean@thegasman.org | sean@thegasman.org]]
'''Kill or Update By:''' December 2021



[[File:sumhorsa.gif|center]]


[[Diving Medicine | BACK]]

@@ Line 27: / Line 27: @@
 | style="width: 263px;" | '''<span>Peak bubble grade (45 minutes exercise)</span>'''
 | style="width: 112px; text-align: center;" | <span><span>60 minutes</span></span>
-| style="text-align: center; width: 140px;" | <span><span>Median 1 (IQR 0 to 2)</span></span>
+| style="text-align: center; width: 140px;" |
-| style="text-align: center; width: 139px;" | <span><span>Median 0 (IQR 0 to 1)</span></span>
+<span><span>Median 1</span></span>
 | style="width: 92px;" | <p style="text-align: center;">&nbsp;</p>
 <span><span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">0.004</span></span>

@@ Line 4: / Line 4: @@
 {|
 |-
-| '''<span>Clinical Bottom Line</span>'''<br/> <span>1. Pre-'dive' exercise reduces bubble grade after diving.</span>
+| <span style="font-size:medium;">'''Clinical Bottom Line'''</span><br/> <span style="font-size:medium;">1. Pre-'dive' exercise reduces bubble grade after diving.</span>
 |}
 <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation/s:'''1. Blatteau J-E, Boussuges A, Castagna, Gempp E, Pontier J-N, Robinet OC, Galland F-M. A 2-hours pre-dive aerobic exercise decreases bubble formation after diving. ICHM-EUBS Proceedings 2005, Desola J (Ed).Barcelona7-10 September 2005.</span>
-<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Clinical Question:''' For individuals breathing compressed air, does exercise before exposure decrease post-exposure bubble formation?</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' gas nuclei, decompression illness, venous gas embolism</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Clinical Question:''' For individuals breathing compressed air, does exercise before exposure decrease post-exposure bubble formation?</span>
 <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:'''Non-blinded randomised crossover trial with intention-to-treat.</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study Patients:''' Healthy volunteer military divers.</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Control group''' (Two groups of N = 16; 16 analysed): No exercise or diving for two days before exposure to 400kPa (approx 30metres) for 30 minutes breathing air in a hyperbaric chamber.</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Experimental group''' (Two groups of N = 16; 16 analysed): As above but two exercise regimens. Either 45 minutes of endurance running at about 70% of maximum theoretical heart rate starting 2 hours before exposure, or 40 minutes at the heart rate corresponding to ventilatory threshold.</span>
@@ Line 15: / Line 17: @@
 <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span>
-{|
+{| style="width: 780px;"
 |-
-| <span><span>'''Non-Event Outcomes'''</span></span>
+| style="width: 263px;" | <span><span>'''Non-Event Outcomes'''</span></span>
-| <span><span>'''Time to outcome/s'''</span></span>
+| style="width: 112px; text-align: center;" | <span><span>'''Time to outcome/s'''</span></span>
-| <span><span>'''Control groups'''</span></span>
+| style="text-align: center; width: 140px;" | <span><span>'''Control groups'''</span></span>
-| <span><span>'''Exercise groups'''</span></span>
+| style="text-align: center; width: 139px;" | <span><span>'''Exercise groups'''</span></span>
-| <span><span>'''P-value'''</span></span>
+| style="text-align: center; width: 92px;" | <span><span>'''P-value'''</span></span>
 |-
-| '''<span>Peak bubble grade (45 minutes exercise)</span>'''
+| style="width: 263px;" | '''<span>Peak bubble grade (45 minutes exercise)</span>'''
-| <span><span>60 minutes</span></span>
+| style="width: 112px; text-align: center;" | <span><span>60 minutes</span></span>
-| <span><span>Median 1 (IQR 0 to 2)</span></span>
+| style="text-align: center; width: 140px;" | <span><span>Median 1 (IQR 0 to 2)</span></span>
-| <span><span>Median 0 (IQR 0 to 1)</span></span>
+| style="text-align: center; width: 139px;" | <span><span>Median 0 (IQR 0 to 1)</span></span>
-| <span><span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">0.004</span></span>
+| style="width: 92px;" | <p style="text-align: center;">&nbsp;</p>
 |-
-| '''<span>Peak bubble grade (40 minutes exercise)</span>'''
+| style="width: 263px;" | '''<span>Peak bubble grade (40 minutes exercise)</span>'''
-| <span><span>60 minutes</span></span>
+| style="width: 112px; text-align: center;" | <span><span>60 minutes</span></span>
-| &nbsp;
+| style="text-align: center; width: 140px;" | &nbsp;
-| &nbsp;
+| style="text-align: center; width: 139px;" | &nbsp;
-| <span><span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">0.023</span></span>
+| style="width: 92px;" | <p style="text-align: center;">&nbsp;</p>
 |}
-<span style="font-size: 120%;">'''Comments:'''</span> <span style="font-size: 120%;">1. Confusing study design involving crossover and two different exercise regimens. We have assumed that no individuals were crossed between the two exercise regimens. Difference in exercise intensity is not clear.</span> <span style="font-size: 120%;">2. Data given for 45 minute group comparison only.</span> <span style="font-size: 120%;">3. Non-peer reviewed short report in conference proceedings.</span>
+<span style="font-size: 120%;">'''Comments:'''</span>
-<span style="font-size: 120%;">'''Appraised by''': Sean Hopson, Mike Bennett, POWH, Sydney&nbsp;; Friday, 1 September 2006Email: [[mailto:sean@thegasman.org| sean@thegasman.org]]</span> <span style="font-size: 120%;">'''Kill or Update By:''' December 2021</span>
+<span style="font-size: 120%;">'''Kill or Update By:''' December 2021</span>
 &nbsp;
-[[File:Sumhorsa.gif|center|Sumhorsa.gif]] <span style="display: block; text-align: center;"></span>
+[[File:Sumhorsa.gif|center|Sumhorsa.gif]]
 <p style="text-align: center;"><span style="font-size: 24px;">[[Diving_Medicine|BACK]]</span></p>

@@ Line 1: / Line 1: @@
 '''<span style="color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 130%;">Pre-compression exercise decreased bubble counts following compressed air breathing </span>'''
-{|
+'''<span style="color: #000000; font-family: Arial,Helvetica,sans-serif; font-size: 130%;">Pre-compression exercise decreased bubble counts following compressed air breathing</span>'''
-| '''<span style'''"font-size: 120%;">Clinical Bottom Line</span>'''<br><span style'''"font-size: 120%;">1. Pre-'dive' exercise reduces bubble grade after diving.</span>
 |-
 |}
 <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation/s:'''1. Blatteau J-E, Boussuges A, Castagna, Gempp E, Pontier J-N, Robinet OC, Galland F-M. A 2-hours pre-dive aerobic exercise decreases bubble formation after diving. ICHM-EUBS Proceedings 2005, Desola J (Ed).Barcelona7-10 September 2005.</span>
-<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Clinical Question:''' For individuals breathing compressed air, does exercise before exposure decrease post-exposure bubble formation?</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Clinical Question:''' For individuals breathing compressed air, does exercise before exposure decrease post-exposure bubble formation?</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' gas nuclei, decompression illness, venous gas embolism</span>
-<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:'''Non-blinded randomised crossover trial with intention-to-treat.</span>
+<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:'''Non-blinded randomised crossover trial with intention-to-treat.</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study Patients:''' Healthy volunteer military divers.</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Control group''' (Two groups of N = 16; 16 analysed): No exercise or diving for two days before exposure to 400kPa (approx 30metres) for 30 minutes breathing air in a hyperbaric chamber.</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Experimental group''' (Two groups of N = 16; 16 analysed): As above but two exercise regimens. Either 45 minutes of endurance running at about 70% of maximum theoretical heart rate starting 2 hours before exposure, or 40 minutes at the heart rate corresponding to ventilatory threshold.</span>
 <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span>
 {|
 |-
-| '''<span style'''"font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Peak bubble grade (45 minutes exercise)</span>''' || <span style'''"display: block; text-align: center;"><span style'''"display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">60 minutes</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">Median 1 (IQR 0 to 2)</span></span> || <span style'''"display: block; text-align: center;"><span style'''"display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">Median 0 (IQR 0 to 1)</span></span> || <span style'''"display: block; text-align: center;"><span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">0.004</span></span>
+| <span><span>'''Non-Event Outcomes'''</span></span>
 |-
-| '''<span style'''"font-family: Arial,Helvetica,sans-serif; font-size: 110%;">Peak bubble grade (40 minutes exercise)</span>''' || <span style'''"display: block; text-align: center;"><span style'''"display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">60 minutes</span></span> ||   ||   || <span style'''"display: block; text-align: center;"><span style="display: block; font-family: Arial,Helvetica,sans-serif; font-size: 110%; text-align: center;">0.023</span></span>
+| '''<span>Peak bubble grade (45 minutes exercise)</span>'''
 |-
 |}
-<span style="font-size: 120%;">'''Appraised by''': Sean Hopson, Mike Bennett, POWH, Sydney ; Friday, 1 September 2006Email: [[mailto:sean@thegasman.org | sean@thegasman.org]]</span>
+<span style="font-size: 120%;">'''Comments:'''</span> <span style="font-size: 120%;">1. Confusing study design involving crossover and two different exercise regimens. We have assumed that no individuals were crossed between the two exercise regimens. Difference in exercise intensity is not clear.</span> <span style="font-size: 120%;">2. Data given for 45 minute group comparison only.</span> <span style="font-size: 120%;">3. Non-peer reviewed short report in conference proceedings.</span>
-<span style="display: block; text-align: center;">
+<span style="font-size: 120%;">'''Appraised by''': Sean Hopson, Mike Bennett, POWH, Sydney&nbsp;; Friday, 1 September 2006Email: [[mailto:sean@thegasman.org| sean@thegasman.org]]</span> <span style="font-size: 120%;">'''Kill or Update By:''' December 2021</span>
-[[File:sumhorsa.gif|center]]
+&nbsp;
-<span style="font-size: 24px;">[[Diving Medicine | BACK]]</span></span></span>
+[[File:Sumhorsa.gif|center|Sumhorsa.gif]] <span style="display: block; text-align: center;"></span>