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Reduced Systemic Inflammation Reduce Likelihood of DCS?

Discussion in 'Diving Medicine' started by Michael Guerrero, Nov 10, 2018.

  1. Michael Guerrero

    Michael Guerrero Solo Diver

    The things I've read on consuming antioxidants have been issues with bio availability sufficient to offset increased exposure to (oxidative stress?) oxygen. Any thoughts on that? I actually take ibuprofen before diving to try and help with the inflammatory of response of bubbles flowing through my body, and am hoping that that, combined with a less inflammatory nutritional program will better offset the negatives with decompression.
  2. Saboteur

    Saboteur Regular of the Pub

    # of Dives: 100 - 199
    Location: Norh America
    Interesting about the NSAID...is there a study on that?
  3. Michael Guerrero

    Michael Guerrero Solo Diver

    Nope, just me implementing something that seems reasonable.

    @Duke Dive Medicine is Dr. Westman participating too?
  4. Duke Dive Medicine

    Duke Dive Medicine Medical Moderator Staff Member

    Hi Michael, I'm not sure. Stay tuned, I'm sure you'll see it published in the near future.

    Re NSAIDS and DCS prevention/prophylaxis, the literature is mixed and I couldn't find anything about prophylactic treatment. I don't imagine there's much risk in an otherwise healthy individual.

    Adjunctive treatment of decompression illness with a non-steroidal anti-inflammatory drug (tenoxicam) reduces compression requirement. - PubMed - NCBI (2003 paper that looked at tenoxicam as an adjunctive treatment for DCS)

    Recompression therapy and adjunctive drug therapy for decompression illness (the bends) (Cochrane review)

    Pharmacological intervention against bubble-induced platelet aggregation in a rat model of decompression sickness. - PubMed - NCBI (looked at ASA and two other antithrombotic agents in DCS in rats)

    Aspirin in the treatment of decompression sickness: what can we learn from French experience? | Westerweel | International Maritime Health

    NSAIDs are not typically given for DCS in the US; I'd be interested to hear what @Dr Simon Mitchell does.

    Best regards,
  5. dmaziuk

    dmaziuk Great White

    What about bubbles in thinner blood? I know a few people who get shiners from various NSAIDs, I myself get nosebleeds if I take them (even low-dose aspirin) for more than 3 days straight. Could they speed up on/off-gassing maybe?
  6. Dr Simon Mitchell

    Dr Simon Mitchell Medical Moderator Staff Member

    Hello DDM and others,

    The NSAID study we published in UHM in 2003 (DDM's first link) is the ONLY randomised double blind controlled trial of ANY intervention in human DCS ever completed. It showed that the patients who received an NSAID as an adjunct to recompression and hyperbaric oxygen essentially recovered more quickly (less recompressions to achieve a standard clinical end point) than those who just received recompression and hyperbaric oxygen alone, although the eventual outcomes were no different between the groups. We think that getting better quicker is a good thing and we therefore do routinely use an NSAID in treating DCS patients in this part of the world. Our thinking is that if we are not going to take any notice of the only RDBCT that exists in our field, there would be little point in doing this sort of work.

    Using an NSAID to try to help prevent DCS is, of course, a completely different thing. There are no relevant data as far as I am aware. There area some hypothetical advantages perhaps. I would not be recommending it to all divers routinely.

    Simon M
  7. TrimixToo

    TrimixToo Regular of the Pub

    # of Dives: 200 - 499
    Location: New York State
    Would Ibuprofen be likely to have the same effects as the Tenoxicam used in the study?
  8. Dr Simon Mitchell

    Dr Simon Mitchell Medical Moderator Staff Member


    Yes, almost certainly it is a "class effect". We just went for tenoxicam because it is a once daily dose and this buys you better compliance from subjects in a drug trial (as compared with them having to remember to take the drug or placebo 4 times per day). But any NSAID in normal recommended doses and dosing intervals should achieve the same thing.

  9. Germie

    Germie Cave Instructor

    # of Dives: 1,000 - 2,499
    Location: Netherlands
    Take aspirin before a dive and some dark chocolate. :wink:

    And some say use antihistamine against hayfever will works also.
  10. divesergeant

    divesergeant Solo Diver

    # of Dives: 500 - 999
    Location: Midwest USA
    All of this makes some sense to this non-medical person. As a benefit, perhaps eating a healthy diet in and of itself helps an over-all healthier body resist complications.

    I use naproxen during dive trips (and when not diving, too much volleyball results in too much pain!) and also take a daily glutathione supplement (supposed to help with systemic infslmmation). But it is difficult to say whether I’d be better or not if I didn’t do these things.

    I have to think that this all must help.

    And I’m all about the dark chocolate diet idea.

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