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Date: Tue, 11 Nov 1997 16:19:45 -0500
From: Bill Mee <wwm@sa*.ne*>
To: Ben Greenhouse <b.greenhouse@ut*.ca*>
CC: cavers@ge*.co*, techdiver@aquanaut.com
Subject: Consequences of Deep Air - Re: Physiology
Ben,

You raise some very interesting questions regarding blood viscosity and
the behavior of blood within the microcirculation.  The reality may be a
lot worse than any of us may have imagined.  Fortunately, for
vertebrates, the apparent viscosity of whole blood decreases in tubes
with diameters less than 0.1cm.  This observation is known as the
Fahraeus-Lindqvist effect and implies that the  shear stress at the
capillary wall decreases as the tube diameter decreases. On the contrary
suspensions of rigid particles display no such behavior.  Mammalian
capillaries range in diameter from 10 micrometers down to 3 micrometers
so that blood cells have to flow down them in single file. For those
capillaries whose diameters are less than that of a cell (7 - 8
micrometers) Red blood cells must deform to pass through the vessel. 
High pressures must be generated locally within the  thin layer of fluid
around the cell in order to deform it and therefore depend considerably
on the elastic properties of the cell.  Anything which impairs the
elastic characteristics of the blood cell may have a profound mechanical
effect on both the cell and the blood vessel.  

Abnormal cells which are hardened or almost spherical cannot be deformed
so easily and therefore cannot pass through the smallest vessels.  In
experiments performed to determine the size of the smallest vessel
through which a red blood cell can transit it was found that anything
smaller than 3 micrometers caused damage to the cells.  Cells which are
artificially hardened or made to swell into a spherical shape (osmosis),
impairing flexibility, cannot pass through pores less than 8 micrometers
in diameter without suffering haemolysis (cell destruction).

In view of the above scenario it would seem that any action which would
artificially "stiffen" blood cells could have a potentially negative
impact in terms of both the mechanical damage to the cells and
capillaries themselves as well as decreased perfusion of the surrounding
tissues. Where critical tissues are concerned, such as those subserving
neurological processes (your brain for instance) the effects of
diminished mass transport could be profound. Since the capillary
micro-circulation plays an essential role in gas transfer during
compression and decompression one might be further concerned as to the
effects of red blood cell rigidity associated with hyperbaric exposures
to air.

Blood is forced to flow through capillaries as little as 3 micrometers
across in the splenic pulp. Normal cells can do this with little
haemolysis; however abnormal spherical cells cannot, such as what occurs
in the disease known as hereditary spherocytosis (sickle cell anemia is
another disease which distorts blood cells). The spleen filters out
blood borne debris as well as housing a large population of B cells, the
immune soldiers which manufacture antibodies in response to an alert by
the T cells.  There was some speculation recently in the DAN journal
regarding "Divers Disease", a flulike illness which sometimes
accompanies hypberbaric exposures. I wouldn’t be at all surprised if the
cause of this problem turns out to be the aftereffects of  red blood
cell rigidity and the consequent build up of haemolized cells in the
spleen and lymph nodes.

Maybe it’s just a coincidence, but deep air diving carries obvious and
subtle neurological effects  and  it poses very problematical
decompression issues for long exposures (empirically and anecdotal
observations).  I personally have experienced fatigue and other flulike
symptoms following exposures to air diving and attribute this to some
form of immune system response.

Eventually, physiologists and hematologists will understand the specific
underlying effects of  excessive hyperbaric air. For the mean time I
think it’s a safe bet to avoid deep air at all costs.

Regards,

Bill Mee

Ben Greenhouse wrote:
> 
> Nelson:
> 
>     There is a little known physical property of fluids called VISCOSITY.  If
> a fluid is thick (like, say...... Molasses... you still with me?)  then it is
> MORE VISCOUS than something not so thick (like say.... water..... Need me to
> repeat that?).  The force required to move a viscous fluid at a constant speed
> is directly proportional to the area of the surface it is touching, the
> velocity it is travelling, and inversely proportional to the diameter of the
> tube.  Now if a usually flexible RBC becomes rigid, my reasoning was that the
> solution it was a part of would become more viscous.
> 
>     I know this is hard to imagine, but next time you're drinking your soda
> through a straw, imagine drinking molasses that way.  See how much harder it
> would be to suck it up?  Good.
> 
>     Now I have no idea how much of a problem this is in diving.  The fact is,
> when I read the message on RBC rigidity, I was studying for an exam in the
> comparative endocrinology of the adrenal gland and the anterior pituitary, and
> had all the interelated effects and causes of hyper and hypotension in my mind
> (including diuresis and dehydration).  I put the question/response up to
> foster further discussion, and increase my knowledge.  I never meant to
> confuse you so much.  I am so sorry
> 
> Ben
> 
> nelson wrote:
> 
> > Ben Greenhouse wrote:
> > >
> > > Nelson;
> > >
> > >     "One" never claimed to be an expert, my rationale behind that
> > > thought was that the blood would become more viscous due to the
> > > increased rigidity of the RBCs.  This in turn would cause an elevation
> > > in blood pressure.  Sound fair to you?
> > >
> > > Ben
> > >
> > > nelson wrote:
> > >
> > > > Ben Greenhouse wrote:
> > > > >
> > > > > Dave:
> > > > >
> > > > >     I'm not too sure of any longterm problems, but I would imagine
> > > that
> > > > > an immediate problem from
> > > > > red blood cell rigidity is hypertension.  The increased work your
> > > heart
> > > > > has to
> > > > > do in this situation may increase nitrogen uptake.  As well, the
> > > reduced
> > > > > blood
> > > > > flow in your circulatory system due to the hypertension may inhibit
> > > > > off-gassing from poorly circulated regions.  Anyone agree/disagree?
> > > > >
> > > > > Dave Nunes wrote:
> > > > >
> > > > > > Bill Mee wrote:
> > > > > > >
> > > > > > > From a strictly physiological viewpoint you will definitely feel
> > >
> > > > > less
> > > > > > > tired and more "energetic" post dive following a lengthy
> > > exposure
> > > in
> > > > > the
> > > > > > > 100' range after breathing a gas mix where helium replaces part
> > > of
> > > > > the
> > > > > > > nitrogen. We know that red blood cells become rigid at high
> > > ppn2s
> > > > > and
> > > > > > > loose some of their hemodynamic characteristics which benefit
> > > plug
> > > > > > > capillary flow.  On the other hand helium is a "fast" highly
> > > mobile
> > > > > gas
> > > > > >
> > > > > > Bill,
> > > > > >
> > > > > > Please forgive my ignorance but, what are the
> > > > > (physiological??/Medical??)
> > > > > > side effects of red blood cells becoming rigid due to high ppn2's,
> > >
> > > can
> > > > > this
> > > > > > cause any problems with normal everyday health (in the long or
> > > short
> > > > > term),
> > > > > > is it permanent damage? What does this do to one's body?
> > > > > >
> > > > > > Ciao
> > > > > >
> > > > > > Dave Nunes
> > > > > > Infoview Client systems
> > > > > >
> > > > > > --
> > > > > > Send mail for the `techdiver' mailing list to
> > > > > `techdiver@aquanaut.com'.
> > > > > > Send subscribe/unsubscribe requests to
> > > > > `techdiver-request@aquanaut.com'.
> > >
> > > > What is the scientific rationale that increased RBC rigidity causes
> > > > hypertension?  That is the nice thing about science...it soon
> > > separates
> > > > the fact from the fiction or BS).  One would also question whether one
> > >
> > > > has the education and background to make such statements.
> > >
> > > --
> > > Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'.
> > > Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'.
> > NOPE.......What is your knowledge base to make such an assumption.
> 
> --
> Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'.
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