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Clinical Investigations: ALTITUDE |

Operation Everest III (Comex’97): Altitude-Induced Decompression Sickness During a Hypobaric Chamber Experiment*: Necessity for Circulating Venous Gas Emboli Monitoring for the Investigators

Florence Molenat, MD; Alain Boussuges, MD, PhD
Author and Funding Information

*From the Service de réanimation médico-chirurgicale (Dr. Molenat), Center Hospitalier du pays d’Aix, Aix-en-Provence; Service de réanimation médicale et d’hyperbarie (Dr. Boussuges), Hopital Sainte-Marguerite, Marseille, France.

Correspondence to: Florence Molenat, MD, Service de réanimation médico-chirurgicale, Center Hospitalier du pays d’Aix, Avenue des Tamaris, 13616 Aix-en-Provence Cedex 1, France



Chest. 2002;121(1):173-177. doi:10.1378/chest.121.1.173
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Introduction: Acute exposure to altitude changes increases the risk of decompression sickness (DCS). Altitude-induced DCS incidence is from 15 to 20% and > 30% above 8,000 m. A particular risk occurs for scientific investigators during hypobaric chamber experiments. Objective: In the present study, we assess whether the detection of nitrogen venous gas emboli (VGE) could help to screen the investigators at risk for altitude-induced DCS.

Material and methods: During a 32-day hypobaric chamber experiment, we collected clinical episodes of DCS symptoms in the investigators, and performed detection of VGE using two-dimensional (2D) echocardiography and pulsed Doppler ultrasonography guided by 2D images, graded from 0 to 5.

Results: Eight investigators made a total of 32 flights, including 8 flights above 8,000 m, with a 15.6% overall incidence of DCS symptoms and a 50% incidence above 8,000 m. VGE detections were systematically performed at or above 8,000 m (eight detections), and some detections were performed at 5,000 m, 6,000 m, and 7,000 m. VGE grades 3 and 4 were present in all but one subject with DCS symptoms and preceded the“ bends” in all cases. VGE detection thus confirmed, in a more sensitive way compared to clinical examination, that our precautionary measures for DCS were not optimized.

Conclusion: VGE monitoring for investigators during hypobaric chamber experiments increased the sensitivity for the detection of subjects at risk for DCS.

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