Difference between revisions of "Mollerlokken"
(Created page with " <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Some evidence that th...") |
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| − | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:"><span style="color:black">Some evidence that the same profiles produce more venous bubbles after wet diving than dry diving.</span></span></span>'''</span> |
| − | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical bottom line:</span></span></span>'''</span> |
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| − | <span style="font-size:large;"><span style="line-height:normal">'''<span style="font-family: | + | <span style="font-size:large;"><span style="line-height:normal">'''<span style="font-family:">1. Wet dives of the same profile trend to producing more detectable VGE bubbles than for dry dives.<br/> 2. Wet dives trended to produce more bubbles that dry dives.</span>'''</span></span> |
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| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">C<span style="font-size:medium;">itation/s:</span></span></span></span>'''<span style="font-size:medium;"><span style="font-family:"><span style="color:black">1.Møllerløkken A, Breskovic T, Palada I, Valic Z, Dujic Z, Brubakk AO. Observation of increased venous gas emboli after wet dives compared to dry dives. Diving Hyperb Med. 2011 Sep;41(3):124-8.<br/> '''Lead author's name and fax: '''Andreas Mollerlokken</span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span>'''<span style="font-family:"><span style="color:black">For scuba divers, does a dive in a dry chamber, compared to the same profile in water, result in fewer detectable venous gas bubbles after the dive?<br/> '''Search Terms:''' Venous gas embolism; experimental diving. decompression illness</span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">The Study:</span></span>'''<span style="font-family:"><span style="color:black">Non-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Experienced male recreational divers<br/> '''Control group''' (N = 7; 7 analysed): Ocean dives either shallow and long (24 msw for 70 mins) or deeper and shorter (54 msw for 20 mins). Calm conditions minimal exercise. Both involved appropriate decompression stops.<br/> '''Experimental group''' (N = 7; 7 analysed): As above for profiles but in a dry hyperbaric chamber seated quietly.</span></span></span></span> |
| − | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family: | + | <span style="font-size:medium;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">The Evidence:</span></span>'''</span></span> |
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{| class="Table" style="border:solid windowtext 1.0pt" | {| class="Table" style="border:solid windowtext 1.0pt" | ||
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| − | | rowspan="2" style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Measure</span></span>'''</span></p> |
| − | | colspan="2" style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | colspan="2" style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Dry dive</span></span>'''</span></p> |
| − | | colspan="2" style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | colspan="2" style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Wet dive</span></span>'''</span></p> |
| − | | rowspan="2" style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Difference</span></span>'''</span></p> |
| − | | rowspan="2" style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | rowspan="2" style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">95% CI</span></span>'''</span></p> |
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| − | | style="width: | + | | style="width: 61px; border: 1pt solid windowtext;" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p> |
| − | | style="width: | + | | style="width: 32px; border: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p> |
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean</span></span>'''</span></p> |
| − | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">SD</span></span>'''</span></p> |
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| style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | | | style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean bubbles/cm-sq over 2 hours-deep dive</span></span>'''</span> |
| − | | style="width: | + | | style="width: 61px; border: 1pt solid windowtext;" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.1</span></span></span></p> |
| − | | style="width: | + | | style="width: 32px; border: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.3</span></span></span></p> |
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.4</span></span></span></p> |
| − | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.6</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.3</span></span></span></p> |
| − | | style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-1.7 to 6.3</span></span></span></p> |
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| style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | | | style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Mean bubbles/cm-sq over 2 hours- shallow dive</span></span>'''</span> |
| − | | style="width: | + | | style="width: 61px; border: 1pt solid windowtext;" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.1</span></span></span></p> |
| − | | style="width: | + | | style="width: 32px; border: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.3</span></span></span></p> |
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.4</span></span></span></p> |
| − | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.0</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.3</span></span></span></p> |
| − | | style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-1.1 to 3.7</span></span></span></p> |
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| style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | | | style="width:167.6pt; border:solid windowtext 1.0pt" width="226" | | ||
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">mean bubbles/cm-sq over 2 hours shallow v deep wet dives</span></span>'''</span> |
| − | | style="width: | + | | style="width: 61px; border: 1pt solid windowtext;" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">Shallow</span></span></span>'''</p> <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.4</span></span></span></p> |
| − | | style="width: | + | | style="width: 32px; border: 1pt solid windowtext;" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"> </p> <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.0</span></span></span></p> |
| − | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:" | + | | style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt">'''<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">Deep</span></span></span>'''</p> <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.4</span></span></span></p> |
| − | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"> </p> <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2.6</span></span></span></p> |
| − | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">1.0</span></span></span></p> |
| − | | style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family: | + | | style="width:80.25pt; border:solid windowtext 1.0pt" width="110" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">-5.3 to 7.3</span></span></span></p> |
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| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. Two groups of seven randomised to either two dry dives 7 days apart, or two wet dives 7 days apart.<br/> 2. Monitored for bubbles by ultrasound every 20 minutes for 2 hours after the dives.<br/> 3. Small numbers and a statistically significant difference is not confirmed on our analysis. The authors report significant differences between wet and dry dives of both profiles. Difference not explained.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett ; Wednesday, 23 December 2020<br/> Email: m.bennett@unsw.edu.au<br/> '''Kill or Update By:''' December 2022</span></span></span></span> |
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Revision as of 03:01, 23 December 2020
Some evidence that the same profiles produce more venous bubbles after wet diving than dry diving.
Clinical bottom line:
|
1. Wet dives of the same profile trend to producing more detectable VGE bubbles than for dry dives. |
Citation/s:1.Møllerløkken A, Breskovic T, Palada I, Valic Z, Dujic Z, Brubakk AO. Observation of increased venous gas emboli after wet dives compared to dry dives. Diving Hyperb Med. 2011 Sep;41(3):124-8.
Lead author's name and fax: Andreas Mollerlokken
Three-part Clinical Question:For scuba divers, does a dive in a dry chamber, compared to the same profile in water, result in fewer detectable venous gas bubbles after the dive?
Search Terms: Venous gas embolism; experimental diving. decompression illness
The Study:Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Experienced male recreational divers
Control group (N = 7; 7 analysed): Ocean dives either shallow and long (24 msw for 70 mins) or deeper and shorter (54 msw for 20 mins). Calm conditions minimal exercise. Both involved appropriate decompression stops.
Experimental group (N = 7; 7 analysed): As above for profiles but in a dry hyperbaric chamber seated quietly.
The Evidence:
Measure |
Dry dive |
Wet dive |
Difference |
95% CI | ||
Mean |
SD |
Mean |
SD | |||
|
Mean bubbles/cm-sq over 2 hours-deep dive |
0.1 |
0.3 |
2.4 |
2.6 |
2.3 |
-1.7 to 6.3 |
|
Mean bubbles/cm-sq over 2 hours- shallow dive |
0.1 |
0.3 |
1.4 |
2.0 |
1.3 |
-1.1 to 3.7 |
|
mean bubbles/cm-sq over 2 hours shallow v deep wet dives |
Shallow 1.4 |
2.0 |
Deep 2.4 |
2.6 |
1.0 |
-5.3 to 7.3 |
Comments:
1. Two groups of seven randomised to either two dry dives 7 days apart, or two wet dives 7 days apart.
2. Monitored for bubbles by ultrasound every 20 minutes for 2 hours after the dives.
3. Small numbers and a statistically significant difference is not confirmed on our analysis. The authors report significant differences between wet and dry dives of both profiles. Difference not explained.
Appraised by:Mike Bennett ; Wednesday, 23 December 2020
Email: m.bennett@unsw.edu.au
Kill or Update By: December 2022
