Daily Aspirin and Diving

[lerpy]

Looking for information on taking a daily dose aspirin and the effects that potentialy could have with diving if there are any. I recognize the concern of bleeding when taking any thinner, but beyond that are there any concerns?

 

[Shugrnutz]

I asked my doctor, during my last physical, he said no issues.

 

[kwinter]

Been doing it for many, many years.

 

[Sanpaku]

Aspirin and other anticoagulant therapy is actually beneficial in decompression sickness. I became curious after reading this passage:

Kurson, R., 2005. Shadow divers: the true adventure of two Americans who risked everything to solve one of the last mysteries of World War II. Random House Incorporated.

Kohl could not respond. Chatterton told Nagle to call the Coast Guard rescue chopper. He shoved aspirins down Kohl's throat, forced him to drink massive amounts of water to reduce the gas volume in his blood, and put an oxygen mask over his face. He used the stethoscope to listen for the gurgling of an embolism in Kohl's blood vessels. A minute later, Kohl began to come around, almost as if he had been reanimated in a mad doctor's laboratory.

Jain, K.K. ed., 2009. Textbook of hyperbaric medicine. Hogrefe Publishing.

Platelet antagonists such as aspirin can reduce platelet aggregation surrounding microbubbles... Antiplatelet drugs hve been used to counteract the platelet aggregation associated with air embolism... Patients who are already on heparin have a better prognosis after air embolism than those who are not anticoagulated... Oral asprin is safer but takes about 30 min to act after ingestion.

Mathieu, D. ed., 2006. Handbook on hyperbaric medicine (Vol. 27). New York:: Springer.

Current standards for the treatment of decompression illness in Europe
On site:

• Oral hydration: recommended only if the patient is fully conscious
• Intravenous rehydration: preferred if a trained healthcare professional is available.
• Normobaric Oxygen (Strongly recommended): The administration of normobaric oxygen allows for the treatment of hypoxemia and favors the elimination of inert gas bubbles
• Resuscitation Drugs and Deep Vein Thrombosis Prophylaxis (Recommended).

• Prevention of hyperthermia
• Aspirin: 500 mg orally in the adult patient (contraindications similar to oral re-hydration)

At the Hospital: only drugs with minimal side-effects should be used, such as:

• Aspirin 500 mg if not already administered and not contraindicated

I now keep aspirin close at hand in my boat drybag first aid kit.

 

[oldschoolto]

I'm on aspirin and blood thinners... Have three deep vain thrombosis clots in lower left leg for over 2 and half years.. Still dive my a$$ off....

 

[morg59]

So would it be advisable for someone who does not take daily aspirin to go ahead and take a few as an extra safety measure an hour before diving?

 

[uncfnp]

So would it be advisable for someone who does not take daily aspirin to go ahead and take a few as an extra safety measure an hour before diving?

Until the experts weigh in, my understanding is the answer is no.

Pharmacological intervention against bubble-induced platelet aggregation in a rat model of decompression sickness

Jean-Michel Pontier, Nicolas Vallée, Mihaela Ignatescu, Lionel Bourdon
Journal of Applied Physiology Published 1 March 2011 Vol. 110 no. 3, 724-729 DOI: 10.1152/japplphysiol.00230.2010

Abstract
Decompression sickness (DCS) with alterations in coagulation system and formation of platelet thrombi occurs when a subject is subjected to a reduction in environmental pressure. Blood platelet consumption after decompression is clearly linked to bubble formation in humans and offers an index for evaluating DCS severity in animal models. Previous studies highlighted a predominant involvement of platelet activation and thrombin generation in bubble-induced platelet aggregation (BIPA). To study the mechanism of the BIPA in DCS, we examined the effect of acetylsalicylic acid (ASA), heparin (Hep), and clopidogrel (Clo), with anti-thrombotic dose pretreatment in a rat model of DCS. Male Sprague-Dawley rats (n = 208) were randomly assigned to one experimental group treated before the hyperbaric exposure and decompression protocol either with ASA (3×100 mg·kg−1·day−1, n = 30), Clo (50 mg·kg−1·day−1, n = 60), Hep (500 IU/kg, n = 30), or to untreated group (n= 49). Rats were first compressed to 1,000 kPa (90 msw) for 45 min and then decompressed to surface in 38 min. In a control experiment, rats were treated with ASA (n = 13), Clo (n = 13), or Hep (n = 13) and maintained at atmospheric pressure for an equivalent period of time. Onset of DCS symptoms and death were recorded during a 60-min observation period after surfacing. DCS evaluation included pulmonary and neurological signs. Blood samples for platelet count (PC) were taken 30 min before hyperbaric exposure and 30 min after surfacing. Clo reduces the DCS mortality risk (mortality rate: 3/60 with Clo, 15/30 with ASA, 21/30 with Hep, and 35/49 in the untreated group) and DCS severity (neurological DCS incidence: 9/60 with Clo, 6/30 with ASA, 5/30 with Hep, and 12/49 in the untreated group). Clo reduced fall in platelet count and BIPA (−4,5% with Clo, −19.5% with ASA, −19,9% with Hep, and −29,6% in the untreated group). ASA, which inhibits the thromboxane A2 pathway, and Hep, which inhibits thrombin generation, have no protective effect on DCS incidence. Clo, a specific ADP-receptor antagonist, reduces post-decompression platelet consumption. These results point to the predominant involvement of the ADP release in BIPA but cannot differentiate definitively between bubble-induced vessel wall injury and bubble-blood component interactions in DCS.

 

[Sanpaku]

Pretty remarkable result for the Plavix, though.

 

[DocVikingo]

The above post regarding aspirin v clopidogrel (originally posted on this forum on January 6, 2011 as post #37 --> http://www.scubaboard.com/community/threads/aspirin-and-diving.256344/page-2#post-5672747) was re-posted on May 6, 2015, along with a supporting follow-up study on the Plavix findings & some board discussion of the topic -- >

http://www.scubaboard.com/community/threads/news-for-divers-taking-plavix-clopidogrel.506358/

Regards,

DocVikingo