Unity through Knowledge Fund 1B Project Report
Project title: Physiology of SCUBA diving
Project leaders: Zeljko Dujic, MD, PhD; Petar Denoble, MD, PhD
Duration of the project: 24 months
Call: 1B – Crossing Borders
Home institution: University of Split School of Medicine
Project budget: 1.110.375 HRK
Other organizations involved:
Divers Alert Network, The Peter B. Benett Center, 6 West Colony Place, Durham, NC 27705 USA, http://www.diversalertnetwork.org/index.asp
Norwegian University of Science and Technology, Olav Kyrres gt. 9, 7489 Trondheim, Norway, http://www.ntnu.no/isb
Project summary: The project entitled “Physiology of SCUBA diving” was awarded to Drs. Zeljko Dujic and Petar Denoble from the Unity through Knowledge Fund of the Croatian Ministry of Science. The project commenced in February 2009 and it was successfully completed in January 2011. It represented a collaborative effort of investigators from Department of Physiology at University of Split School of Medicine, Diving Alert Network, a central international organization dealing with diving safety, Duke University, Norwegian University of Science and Technology, Hannover Medical School, and Antwerp University Hospital. Besides answering important scientific questions, this project also helped to form a tight network of researchers across the globe that share same research interests. Moreover, this project served as a framework for education of young scientists and helped them establishing their own fields of research, thus supporting further development of Croatian science. One of the goals in this project was to further investigate the mechanisms that cause appearance of physiological changes in human body resulting from SCUBA diving, especially in cardiovascular system. Along this line, we examined whether intense diving over many years has any chronic negative effects on cardiovascular function. Lastly, the largely unknown effects of extreme diving on cardiovascular system were also explored. The end point of this project was to understand the impact of diving on human health and to identify the procedures and mechanisms that reduce the risks associated with diving.
- Investigation of effects of exercise on gas bubble distribution in circulation.
- Introduction of novel methodology for determination of blood nitrite and endothelial progenitor cells.
- Collection of data for assessment of genetic expression following the dives.
- Collection of data on individual susceptibility to gas bubble production and arterialization.
- Collection of data on divers that suffered DCS is ongoing.
- Investigation of effects of multiday diving regimens on cardiac, pulmonary and vascular function.
- Detailed investigation of the effect of multiday diving with air and nitrox on arterial/endothelial function.
- Measurement of endothelial progenitor cells and blood nitrite following multiday diving.
- Introduction of novel methodology for assessment of endothelial function – acquisition of custom-made software for data analysis and training of the personnel.
- Introduction of novel echocardiographic approaches - training of the personnel.
- Testing the novel, custom-made prototypes for underwater assessment of blood pressure and ECG
Novel methodologies introduced:
- Blood nitrite measurement.
- Endothelial progenitor cells (number and functional tests).
- Flow-mediated dilation using special holder and software.
- Cutting edge echocardiographic analysis using EchoPack software and Vivid q ultrasound.
- Contrast echocardiography for assessment of PFO and IP shunts.
- Muscle sympathetic nerver activity (MSNA).
International projects submitted:
- REGPOT 2010 (4 million €, not funded, resubmission planned for 2011. Integration of Medical School, Hospital, Industry, International collaborators)
- FP7 MC ITN Phypode (funded 2010, 3 million €, 230.000 € to USSM)
- Norwegian Labor Directorate project (funded; 50 000 €)
- US Navy project (submitted; 70.000 US$ as a pilot for 450-500.000 US$)
- MARES project – project with partner from industry (negotiation in February 2011)
- Published: 9
- Submitted: 1
- In preparation: 3-4
- Duska Glavas, 2010 (Completed)
- Jaksa Zanchi
- Nada Bilopavlovic
- Svein-Erik Gaustad (international student from Norway)
- Approved student position through Marie Curie ITN Phypode project
- 8 invited lectures
- 2 international conferences (total 6 abstracts)
- 2 book chapters
- Public media: web, national TV, newspapers
International collaboration – visits to Split:
- Prof. Brubakk (NTNU)
- Dr. Denoble (DAN)
- Prof. Wisloff (NTNU)
- Dr. Eftedal (NTNU)
- Dr. Mollerloken (NTNU)
- Dr. Gerth (US Navy)
- Dr. Pollock (Duke University)
- S. Gaustad (NTNU)
- Dr. Losiewicz (US Navy)
- Dr. Van Craenenbroeck (Antwerp University Hospital)
- Dr. Sieber (IMEGO)
- Prof. Forster (MCW)
- LCDR Swiergosz (US Navy)
- Dr. Johnson (Mayo clinic)
International collaboration – visits from Split:
- Dr. Dujic to The German Sport University (DSHS) (Dr. Hoffman), The French Underwater Federation/Andre Grousset (Toulon), NTNU (dr Brubakk)
- Drs. Dujic, Ljubkovic and Breskovic to University of Western Ontario (Dr. Shoemaker, London, Canada) and Cleveland Clinic Foundation (Drs. Roizen and Golubic, USA)
- Dr. Modun to Hannover Medical School (Dr. Tetzlaff)
- Dr. Cikes-Culic to Antwerp University Hospital (Dr. Conraads)
- Drs. Breskovic and Obad to Liverpool (Course for ultrasound/FMD analysis)
- Dr. Obad and Bakovic to NTNU (Dr. Wisloff)
- DAN (Deep diving field studies; Expert advice)
- NTNU (Animal studies; Genetic studies)
- Duke University
- Hannover Medical School
- Antwerp University Hospital
Involved personnel from USSM:
- Dr. Zeljko Dujic: project leader
- Dr. Marko Ljubkovic: co-worker
- Dr. Jasna Marinovic: co-worker
- Dr. Toni Breskovic: co-worker
- Dr. Darija bakovic: co-worker
- Dr. Ante Obad: co-worker
- Dr. Petra Zubin: co-worker
- Dr. Jasenka Kraljevic: co-worker