{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:53:53Z","timestamp":1783040033682,"version":"3.54.6"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000006","name":"Office of Naval Research","doi-asserted-by":"publisher","award":["N00014\u201023\u20101\u20102757"],"award-info":[{"award-number":["N00014\u201023\u20101\u20102757"]}],"id":[{"id":"10.13039\/100000006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003500","name":"Universit\u00e0 degli Studi di Padova","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003500","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"abstract":"\n Abstract<\/jats:title>\n \n Understanding of pulmonary gas exchange measurements in divers at sea is incomplete. In this study, arterial blood gases (ABGs) were measured in SCUBA divers breathing compressed air and pedalling at depths of 15 or 40\u00a0m in seawater (msw). In breath\u2010hold divers (BHDs), ABGs were obtained before, at 15, 25 or 40\u00a0msw, and at the surface before breathing. Lung ultrasound was also performed in both groups before, at 15\u00a0msw, and after all the dives. Blood syndecan\u20101 (SDC\u20101) and heparan sulfate (HS) were also measured. Among 10 SCUBA divers (one female; ages 32\u201357), PaO\n 2<\/jats:sub>\n increased at depth as predicted. Among 12 BHDs (three female, ages 33\u201362), PaO\n 2<\/jats:sub>\n rose at depth and decreased on surfacing; two participants at 15\u00a0msw and one at 25\u00a0msw did not develop bottom hyperoxaemia. Lung ultrasound was normal at 15\u00a0msw, while interstitial oedema or pleural irregularities were found after surfacing in most SCUBA divers and BHDs. In SCUBA divers, significant post\u2010dive increases occurred in SDC\u20101 and HS; in BHDs, a significant increase was found in HS after the 15 and 25\u00a0msw dives, while SDC\u20101 increased after all depths. Compared with warm\u2010freshwater experiments, ABG values in SCUBA divers were similar, while in BHDs relative hypoxaemia at depth was less common. Elevated levels of glycocalyx markers were consistent with endothelial stress, possibly providing a mechanism for fluid to accumulate in the pulmonary interstitium and explaining the ultrasound abnormalities.\n \n \n image<\/jats:alt-text>\n <\/jats:graphic>\n <\/jats:boxed-text>\n <\/jats:p>\n <\/jats:sec>\n \n Key points<\/jats:title>\n \n \n \n The understanding of lung\u2013environment interactions during open\u2010sea diving remains limited.<\/jats:p>\n <\/jats:list-item>\n \n We integrated underwater and surface arterial blood gases, lung ultrasound and endothelial glycocalyx markers (syndecan\u20101, heparan sulfate) to quantify gas\u2010exchange perturbations and lung stress in SCUBA and breath\u2010hold divers (BHDs).<\/jats:p>\n <\/jats:list-item>\n \n \n SCUBA: arterial oxygen (PaO\n 2<\/jats:sub>\n ) increased at depth and returned to baseline at the surface; BHDs: PaO\n 2<\/jats:sub>\n increased at depth (except in three participants), then values fell to hypoxaemia on surfacing.\n <\/jats:p>\n <\/jats:list-item>\n \n Post\u2010dive lung ultrasound showed subclinical interstitial oedema \u2013 from focal B\u2010lines to diffuse patterns \u2013 and pleural irregularities more marked after deeper dives and in BHDs than in SCUBA.<\/jats:p>\n <\/jats:list-item>\n \n Circulating glycocalyx markers increased post\u2010dive, consistent with endothelial stress.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1113\/jp290397","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T11:35:54Z","timestamp":1776080154000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gas exchange and pulmonary stress variations during SCUBA and breath\u2010hold diving in open seawater"],"prefix":"10.1113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7556-6928","authenticated-orcid":false,"given":"Matteo","family":"Paganini","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-0628","authenticated-orcid":false,"given":"Tommaso Antonio","family":"Giacon","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7359-2690","authenticated-orcid":false,"given":"Simona","family":"Mrakic\u2010Sposta","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology National Research Council (IFC\u2010CNR) Milano Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Martani","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danilo","family":"Cialoni","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Zucchi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences University of Padova Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Maffei","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care, and HBOT A.O.R.N. Antonio Cardarelli Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Cifali","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care, and HBOT A.O.R.N. Antonio Cardarelli Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Marmo","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care, and HBOT A.O.R.N. Antonio Cardarelli Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3548-1097","authenticated-orcid":false,"given":"Enrico M","family":"Camporesi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine University of South Florida Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4432-0332","authenticated-orcid":false,"given":"Richard E","family":"Moon","sequence":"additional","affiliation":[{"name":"Center for Hyperbaric Medicine and Environmental Physiology, Department of Anesthesiology Duke University Medical Center Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6595-7944","authenticated-orcid":false,"given":"Gerardo","family":"Bosco","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences University of Padova Padova Italy"},{"name":"Departement of Medicine and Aging Sciences University G d'Annunzio of Chieti\u2010Pescara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"issue":"2","key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1139\/cjpp-2019-0341","article-title":"Vascular dysfunction following breath\u2010hold diving","volume":"98","author":"Barak O. 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