Effect of oxygen breathing and perfluorocarbon emulsion treatment on air bubbles in adipose tissue during decompression sickness

Abstract

Decompression sickness (DCS) after air diving has been treated with success by means of combined normobaric oxygen breathing and intravascular perfluorocarbon (PFC) emulsions causing increased survival rate and faster bubble clearance from the intravascular compartment. The beneficial PFC effect has been explained by the increased transport capacity of oxygen and inert gases in blood. However, previous reports have shown that extravascular bubbles in lipid tissue of rats suffering from DCS will initially grow during oxygen breathing at normobaric conditions. We hypothesize that the combined effect of normobaric oxygen breathing and intravascular PFC infusion could lead to either enhanced extravascular bubble growth on decompression due to the increased oxygen supply, or that PFC infusion could lead to faster bubble elimination due to the increased solubility and transport capacity in blood for nitrogen causing faster nitrogen tissue desaturation. In anesthetized rats decompressed from a 60-min hyperbaric exposure breathing air at 385 kPa, we visually followed the resolution of micro-air bubbles injected into abdominal adipose tissue while the rats breathed either air, oxygen, or oxygen breathing combined with PFC infusion. All bubble observations were done at 101.3 kPa pressure. During oxygen breathing with or without combined PFC infusion, bubbles disappeared faster compared with air breathing. Combined oxygen breathing and PFC infusion caused faster bubble disappearance compared with oxygen breathing. The combined effect of oxygen breathing and PFC infusion neither prevented nor increased transient bubble growth time, rate, or growth ratio compared with oxygen breathing alone. We conclude that oxygen breathing in combination with PFC infusion causes faster bubble disappearance and does not exacerbate transient bubble growth. PFC infusion may be a valuable adjunct therapy during the first-aid treatment of DCS at normobaric conditions.