Brebeck

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Breathing nitrox28 (28% oxygen) while scuba diving may produce fewer bubbles in the hour after surfacing

1. Weak evidence there were fewer bubbles after breathing nitrox
2. Non-random evidence of more bubbles in female divers

Citation/s: 1. Brebeck AK, Deussen A, Range U, Balestra C, Cleveland S, Schipke JD. Beneficial effect of enriched air nitrox on bubble formation during scuba diving. An open-water study. Journal of sports sciences. 2018 Mar 19;36(6):605-12
Lead author's name and fax: Anne-Kathrin Brebeck. Contact Jochen Schipke j.schipke@gmx.org

Three-part Clinical Question:For scuba diving, does breathing an oxygen reduced air mix compared to air result in fewer detectable velous bubbles after diving?
Search Terms: Venous gas embolism; doppler; decompression

The Study:
Double-blinded concealed randomised controlled trial with intention-to-treat.
The Study Patients: Adult volunteer divers
Control group (N = 54; 54 analysed): Air breathing during a standard dive to 24 msw for 62 minutes
Experimental group (N = 54; 54 analysed): Enriched air breathing of 28% oxygen (nitrox28) for the same dive.

The Evidence:

Outcome

Time to Outcome

Air

Nitrox

Relative Risk Reduction

Absloute Risk Reduction

NNT

No bubbles detected

60 mins

0.11

0.07

36%

0.04

25

95% CIs:

-62% to 100%

-0.07 to 0.15

NNT = 7 to INF

NNH = 15 to INF

 

Measure

Air Group

Nitrox Group

Difference

95% CI

Mean

SD

Mean

SD

Bubbles detected per minute

30

32

16

16

14

-108 to 136

Comments:
1. Trial powered for one-sided statistical testing for a 25% reduction in subclavian bubbles with nitrox. The figure for that comparison is not given.
2. The authors exhaustively analyzed the data for differences between vein sites and time with few important differe nces noted.
3. There were more bubbles detected in females than males
4. The authors report in the abstract, but not in results that "more bubbles were
counted in the air-group than in the air28-group (pooled vein: early: 1845 vs. 948; P = 0.047. One may get the feeling the authors are stretching for meaning here.
                                                        5. Authors measured bubbles at three differnt sites - subclavian, jugular and femoral

Appraised by: Michael Bennett m.bennett@iunsw. edu.au ; Monday, 13 April 2020

Kill or Update By:April 2022