End tidal CO2 in recreational rebreather divers on surfacing after decompression dives.

INTRODUCTION: Deep dives using rebreather devices result in oxygen exposures that carry a risk of cerebral oxygen toxicity. Elevation of arterial CO2 levels increases this risk. CO2 retention may occur during the deep working phases of dives, but it has not been investigated in 'real world' dives at the end of resting decompression when oxygen exposures are peaking, often to levels higher than recommended maxima.

METHODS: We conducted an observational field study to measure end tidal CO2 (Petco2) in divers surfacing after decompression. Sixteen rebreather divers conducted two dives and two completed one dive (a total of 34 dives) to depths ranging from 44-55 msw. Bottom times ranged from 35 to 56 min and time spent on decompression ranged from 40 to 92 min. The first breaths on reaching the surface after removing the rebreather mouthpiece were taken through a portable capnograph. The Petco2 was recorded for the first breath that produced a clean capnography trace. Petco2 measurement was repeated for each subject 2-3 h after diving to give paired observations.

RESULTS: There were no differences between mean surfacing Petco2 [36.8 mmHg (SD 3.0)] and the mean Petco2 made later after diving [36.9 mmHg (SD 4.0)]. One subject on one dive returned a surfacing Petco2 higher than a nominal upper limit of 45 mmHg.

DISCUSSION: We found no general tendency to CO2 retention during decompression. It is plausible that breaching oxygen exposure limits during resting decompression is less hazardous than equivalent breaches when exercising at deep depths. Mitchell SJ, Mesley P, Hannam JA. End tidal CO2 in recreational rebreather divers on surfacing after decompression dives.