Abstract
Aviation deep vein thrombosis is a challenge poorly understood in modern aviation. The aim of the present project was to determine if cabin decompression might favor formation of vascular bubbles in commercial air travelers. Thirty commercial flights were taken. Cabin pressure was noted at take-off and at every minute following, until the pressure stabilized. These time–pressure profiles were imported into the statistics program R and analyzed using the package SCUBA. Greatest pressure differentials between tissues and cabin pressures were estimated for 20, 40, 60, 80 and 120 min half-time compartments. Time to decompress ranged from 11 to 47 min. The greatest drop in cabin pressure was from 1022 to 776 mBar, equivalent to a saturated diver ascending from 2.46 msw depth. Mean pressure drop in flights >2 h duration was 193 mBar, while mean pressure drop in flights <2 h was 165 mBar. The greatest drop in pressure over 1 min was 28 mBar. Over 30 commercial flights it was found that the drop in cabin pressure was commensurate with that found to cause bubbles in man. Both the US Navy and the Royal Navy mandate far slower decompression from states of saturation, being 1.7 and 1.9 mBar/min respectively. The median overall rate of decompression found in this study was 8.5 mBar/min, five times the rate prescribed for USN saturation divers. The tissues associated with hypobaric bubble formation are likely slower than those associated with bounce diving, with 60 min a potentially useful index.
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Acknowledgments
Peter Buzzacott is currently employed by the Divers Alert Network in North Carolina, USA. The photographs in Fig. 1 were taken by Carol Sugars and are reproduced with permission. The authors thank Professor Alf O. Brubakk for his insightful assistance at the commencement of this research.
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Buzzacott, P., Mollerlokken, A. Could some aviation deep vein thrombosis be a form of decompression sickness?. J Thromb Thrombolysis 42, 346–351 (2016). https://doi.org/10.1007/s11239-016-1368-x
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DOI: https://doi.org/10.1007/s11239-016-1368-x