10 - Gas-bubble dynamics in the treatment of gas-bubble disease: Merging medicine and math

Abstract

Although prompt treatment of decompression sickness (DCS) and arterial gas embolism (AGE) is best, diffusion of gases through bubbles and streaming around bubbles likely contributes to better than expected outcomes even after prolonged delays. Quantitative analysis within the limits of the best available model (LHV3) is provided for the application of normobaric oxygen, pressure, and both combined (hyperbaric oxygen) on bubble size. This demonstrates that breathing oxygen before commencing hyperbaric treatment is very effective in shrinking “uncovered” or “bare” bubbles. The analysis further demonstrates that helium bubbles will extinguish faster than the same size nitrogen bubbles. Further, treatment with the USN Table 6 would be expected to eliminate even the largest likely sizes of uncovered bubbles. No model of bubble dynamics presently available accurately predicts the duration of persistence of any size of bubble surrounded by a skin of phospholipids or protein molecules, but it is clear that such bubbles could survive for very prolonged periods. Whether covered or not, the diffusion characteristics of elongated vascular bubbles are not known, but these survive for a longer period than spherical bubbles and first shrink in a linear manner until they become spherical, at which time they will release from contact with vessel walls and then move in the direction of blood flow. Microparticles and microbubbles play an important role in the overall effects of DCS and AGE. The chapter demonstrates how medicine and mathematics can collaborate in approaches to gas-bubble disease.