@article{0226eff1-b37f-4872-8c6d-b3c180be3d96,
  abstract     = {{<p>Introduction: Divers are reported to have a lower ventilatory response to elevated levels of carbon dioxide (CO₂) than non-divers. Hypoventilation with CO₂ retention during diving is potentially dangerous. It is unknown if CO₂ retention is largely inherited or develops during diving training. We aimed to investigate if a military dive training course would influence the ventilatory response to CO₂. Methods: Novice rebreather Divers with Amphibious Rangers as controls were tested at baseline, after 12 weeks of water exercise training, and after 15 weeks of diving: participants rebreathed in a Douglas bag filled with an initial 100% oxygen, resulting in increasing levels of inspiratory CO₂ (iCO₂). The test was performed until symptom-limitation or an expiratory CO₂ of 8.0 kPa. To decrease conscious control of breathing, participants were distracted with a memory game during the test. Differences between groups and over time were analyzed using independent and paired t-tests. Results: Ten Divers and six Amphibious Rangers completed baseline testing and eight Divers completed all tests. Divers had a statistically significant higher Minute Ventilation (V'E) after dive training, compared to after water exercise training and baseline, at all levels of iCO₂. However, the change in Hypercapnic ventilatory response (HCVR) before and after dive training across pCO₂ values 5.0-7.9, did not reach statistical significance. At baseline, Amphibious Rangers had a non-significant higher V'E compared to Divers at higher levels of iCO₂. Conclusion: A military rebreather diving program might be associated with increased ventilatory response to CO₂.</p>}},
  author       = {{Ekman, Lars and Sjöblom, Clara and Ekström, Magnus and Frånberg, Oskar}},
  issn         = {{1066-2936}},
  keywords     = {{carbon dioxide retention; diving; rebreather-semi-closed circuit respiratory response}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{4}},
  pages        = {{587--597}},
  publisher    = {{Undersea and Hyperbaric Medical Society}},
  series       = {{Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc}},
  title        = {{Increased ventilatory response to carbon dioxide after dive training}},
  volume       = {{52}},
  year         = {{2025}},
}