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Proposed Thalmann algorithm air diving decompression table for the Swedish Armed Forces

Silvanius, Mårten ; Rullgård, Hans ; Eckström, Magnus and Frånberg, Oskar LU (2023) In Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc 50(2). p.67-83
Abstract

The Swedish Armed Forces (SwAF) air dive tables are under revision. Currently, the air dive table from the U.S. Navy (USN) Diving Manual (DM) Rev. 6 is used with an msw-to-fsw conversion. Since 2017, the USN has been diving according to USN DM rev. 7, which incorporates updated air dive tables derived from the Thalmann Exponential Linear Decompression Algorithm (EL-DCM) with VVAL79 parameters. The SwAF decided to replicate and analyze the USN table development methodology before revising their current tables. The ambition was to potentially find a table that correlates with the desired risk of decompression sickness.  New compartmental parameters for the EL-DCM algorithm, called SWEN21B, were developed by applying maximum likelihood... (More)

The Swedish Armed Forces (SwAF) air dive tables are under revision. Currently, the air dive table from the U.S. Navy (USN) Diving Manual (DM) Rev. 6 is used with an msw-to-fsw conversion. Since 2017, the USN has been diving according to USN DM rev. 7, which incorporates updated air dive tables derived from the Thalmann Exponential Linear Decompression Algorithm (EL-DCM) with VVAL79 parameters. The SwAF decided to replicate and analyze the USN table development methodology before revising their current tables. The ambition was to potentially find a table that correlates with the desired risk of decompression sickness.  New compartmental parameters for the EL-DCM algorithm, called SWEN21B, were developed by applying maximum likelihood methods on 2,953 scientifically controlled direct ascent air dives with known outcomes of decompression sickness (DCS). The targeted probability of DCS for direct ascent air dives was ≤1% overall and ≤1‰ for neurological DCS (CNS-DCS). One hundred fifty-four wet validation dives were performed with air between 18 to 57 msw. Both direct ascent and decompression stop dives were conducted, resulting in incidences of two joint pain DCS (18 msw/59 minutes), one leg numbness CNS-DCS (51 msw/10 minutes with deco-stop), and nine marginal DCS cases, such as rashes and itching. A total of three DCS incidences, including one CNS-DCS, yield a predicted risk level (95% confidence interval) of 0.4-5.6% for DCS and 0.0-3.6% for CNS-DCS. Two out of three divers with DCS had patent foramen ovale. The SWEN21 table is recommended for the SwAF for air diving as it, after results from validation dives, suggests being within the desired risk levels for DCS and CNS-DCS.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
decompression sickness, decompression tables, deterministic modeling, diving research, military diving, probabilistic modeling
in
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc
volume
50
issue
2
pages
17 pages
publisher
Undersea and Hyperbaric Medical Society
external identifiers
  • pmid:37302072
  • scopus:85161674727
ISSN
1066-2936
language
English
LU publication?
yes
id
d7ead3d1-a7bd-406c-b6b2-272997ea811a
date added to LUP
2023-09-20 14:32:09
date last changed
2024-04-19 01:29:23
@article{d7ead3d1-a7bd-406c-b6b2-272997ea811a,
  abstract     = {{<p>The Swedish Armed Forces (SwAF) air dive tables are under revision. Currently, the air dive table from the U.S. Navy (USN) Diving Manual (DM) Rev. 6 is used with an msw-to-fsw conversion. Since 2017, the USN has been diving according to USN DM rev. 7, which incorporates updated air dive tables derived from the Thalmann Exponential Linear Decompression Algorithm (EL-DCM) with VVAL79 parameters. The SwAF decided to replicate and analyze the USN table development methodology before revising their current tables. The ambition was to potentially find a table that correlates with the desired risk of decompression sickness.  New compartmental parameters for the EL-DCM algorithm, called SWEN21B, were developed by applying maximum likelihood methods on 2,953 scientifically controlled direct ascent air dives with known outcomes of decompression sickness (DCS). The targeted probability of DCS for direct ascent air dives was ≤1% overall and ≤1‰ for neurological DCS (CNS-DCS). One hundred fifty-four wet validation dives were performed with air between 18 to 57 msw. Both direct ascent and decompression stop dives were conducted, resulting in incidences of two joint pain DCS (18 msw/59 minutes), one leg numbness CNS-DCS (51 msw/10 minutes with deco-stop), and nine marginal DCS cases, such as rashes and itching. A total of three DCS incidences, including one CNS-DCS, yield a predicted risk level (95% confidence interval) of 0.4-5.6% for DCS and 0.0-3.6% for CNS-DCS. Two out of three divers with DCS had patent foramen ovale. The SWEN21 table is recommended for the SwAF for air diving as it, after results from validation dives, suggests being within the desired risk levels for DCS and CNS-DCS.</p>}},
  author       = {{Silvanius, Mårten and Rullgård, Hans and Eckström, Magnus and Frånberg, Oskar}},
  issn         = {{1066-2936}},
  keywords     = {{decompression sickness; decompression tables; deterministic modeling; diving research; military diving; probabilistic modeling}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{67--83}},
  publisher    = {{Undersea and Hyperbaric Medical Society}},
  series       = {{Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc}},
  title        = {{Proposed Thalmann algorithm air diving decompression table for the Swedish Armed Forces}},
  volume       = {{50}},
  year         = {{2023}},
}