Apple Juice

[SCUBAMedic]

One of the guys I dive with is a big believer in the use of Apple juice in preventing and treating DCS

Does anyone have good evidence of the benefit of this, reserch docs would be appricated

Cheers

 

[Scubaroo]

Beats fairydust.

Seriously, I'd be interested in hearing anything further on the subject.

 

[DocVikingo]

.... whatever apple juice contributes to the prevention or treatment of DCS almost certainly doesn't extend beyond the basic hydration it provides.

Best regards.

DocVikingo

 

[Catt]

Apple Juice thats got to be the strangest thing i have every heard, i suppose your not going to get dehydrated however i can see no other reason why Apple Juice would be any better than Orange Juice please let us know what does your diver friend base his belief on

 

[Charlie99]

All the other stuff above is for strokes. Grape is the only allowed flavor, sipped through a long straw. :banana:

Charlie


(for the literal minded -- there is ZERO scientific evidence to support the above observation)

 

[SCUBAMedic]

I believe that the Pot that he trained at used it ??? Pos. is not a diruritic ???

I simple don't know but he makes a convincing case

Whats your view on fluid replacement of 1 liter an hour for DCS ???

 

[ssra30]

SCUBAMedic once bubbled...
I believe that the Pot that he trained at used it ??? Pos. is not a diruritic ???

I simple don't know but he makes a convincing case

Whats your view on fluid replacement of 1 liter an hour for DCS ???

As far as diuretic goes, you definitely don't want to use it in someone with DCS as it would make you even more dehydrated.
I also don't think that apple juice has any diuretic effect. Some herbal tea is a mild diuretic. Alchohol via a different mechanism than diuretic will also cause you to urinate more and get dehydrated.

Fluid replacement should help some in theory as it would provide more volume for gas to dissolve in but in practice, it probably will not help much. If you give IV fluid that has similar concentration as plasma (similar osmotic pressure), only 1/12 of it remains in the intravascular compartment after equilibrium. Apple juice is much less concentrated than plasma so most will just leak out into surrounding tissue. As a volume expander by mouth, tomato juice is a much better as it has a lot more salt in it hence closer to plasma's solute concentration .

In someone who is not dehydrated or mildly dehydrated, I am not sure how much the body will be able to handle extra volume, especially when they don't have significant fluid loss (for example burned patient).
In young healthy person, giving a quick bolus of 2-3 liters should be tolerable but in older person especially if they have underlying disease, a liter an hour for a few hours may not be a good idea.

 

[ssra30]

Opps, just have another thought about forcing fluid through someone with DCS. The more I think about it , it may help, make no difference or make it worse, depending on location of the bubble.
The way I see it is that when you have nitrogen bubble form on the arterial side, if the bubble completely block the vessel, whatever fluid you push will not get anywhere near the block vessel due to back pressure.
The increase volume that you will gain by giving more fluid will be offset by increased urination. This response occurs relatively fast as long as the kidney and heart function normally.
Worse, if bubble formation only cause partial obstruction, increasing arterial flow by giving large amount of fluid could possibly wash the bubble downstream to smaller vessels and cause complete obstruction.
If bubbles occur in small capillary bed, I suppose the increase fluid could theoretically wash the bubble into venous side where the bubble could be returned safely back to lung for quick gas exchage.
Just a speculation here...

 

[SCUBAMedic]

I know alot of u work closely with several chambers around the world. So what fluids do you give your patients in the chamber and why

Cheers