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> I feel I still disagree; from what you said yourself, there does
>seem to tbe a connection between shunting and DCI, in my view. I
>disagree with the need for separate tables because the numbers are still
>so small. On the other hand, how much data is there on complement in
>observed human DCI cases?
Well part of the problem with this whole thread is people use different
terms for the same thing and the same term for different things.
Decompression Illness is the NEW terminology proposed by the UHMS a year or
2 ago. It makes no distinction between what was called pulmonary
barotrauma and intravascular gas due to decompression. The end result is
the same, gas in the cerebral vessels. Treatment is the same (multiple
sessions of HBO). Now if intravenous gas can get to the brain circulation
by shunting across a PFO, people with a PFO would be at a greater risk of
DCI, and indeed we know that in experimental models, even small amounts of
gas in the cerebral circulation is bad. We also know there are plenty of
people diving with a PFO who don't get DCI. Ipso-facto, other mechanisms
are operating here.
Furthermore, in people with different sorts of lung disease, bubbles spill
over into the arterial circulation. The PFO camp should also be examining
diving candidates for the capacity of their lungs to soak up venous bubbles.
The point is that we are still very unclear as to what DCI actually is. I
am pretty sure bubble trapping is not at all important. I am sure that
granuolcytes and platelets ARE involved.
> There does seem to be an opening to inhibit the alternative
>complement pathway with chronic drug usage; lowering your DCI risk. If
>what you say (about the relative risks) is true, then we are all being
>foolish in not taking an aspirin a day!
Aspirin itself is bad because it interferes with pulmonary and eustacian
tube surfactant function. You are on the right track however...
> I'm off to the chemist. :-)
Me too!
/rat
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shelps@ac*.ma*.ad*.ed*.au*|Stephen Helps PhD Ack! ___/|
FAX (08)232-3283 |Anaesthesia & Intensive Care \O.o|
Voice (08)224-5495 |University of Adelaide =(___)=
|ADELAIDE, 5005, South Australia U
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Are you at the point where you don't have the time to find solutions
to the problems that are taking up all your time??? - Mark C. Davison
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