title: Abnormal serum biochemistries in association with arterial gas embolism.
abstract: Although diving-associated arterial gas emboli have been thought to embolize the cerebral circulation preferentially, more recent evidence suggests that gas bubbles disseminate widely and may cause dysfunction in multiple organ systems. We performed a retrospective survey of the records of patients presenting with diving-associated gas embolism over a 10-yr period to determine the maximal levels of serum transaminases and lactate dehydrogenase after a diving accident. Twenty-nine subjects with arterial gas embolism were identified whose dive profiles suggested that decompression sickness was unlikely. Maximal transaminase levels (aspartate amino transaminase = 442 +/- 187 IU/L; alanine amino transaminase = 315 +/- 205 IU/L) and lactate dehydrogenase level (800 +/- 227 IU/L) were significantly greater in the gas embolism patients than those levels measured in a group of normal individuals undergoing training dives of similar depth and duration. These preliminary studies suggest that arterial gas embolism frequently produces significant abnormalities in serum enzyme activity in sport divers whose dives would not be expected to produce decompression sickness. Arterialized gas bubbles may circulate widely, causing injury outside of the cerebral circulation.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of California, San Diego 92126, USA.
authors.forename: R M
authors.initials: RM
authors.lastname: Smith
authors.forename: T S
authors.initials: TS
authors.lastname: Neuman
mesh_terms: D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D004242:Diving / Q000009:adverse effects*; D004618:Embolism, Air / Q000097:blood / Q000201:enzymology* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase