Conditioned? Respiratory pattern from diving?

[Ninjapug]

Modern ventilators have visual waveform displays that indicate respiratory patterns. If a patient is completely( no spontaneous respirations) dependent on mechanical ventilation, the pattern is uniform to specific ( Tidal Volume, Rate of Respirations/ Minute, etc). parameters. I recently had a pulmonary function study and was asked to "breathe normally" for 2 minutes. A nose clip was placed and I was instructed to breathe normally, by mouth, into a mouthpiece attached to an analyzer on "Room Air" which is healthcare speak for the air we breath (21% O2, N2 78%). Not to insult anyone's intelligence, but this is the standard mixture of compressed air we all used as students and still use after certification. Some will sacrifice depth for bottom time and use Nitrox or other mixtures after proper certification. The Respiratory Therapist immediately inquired if I been on ventilatory support, long term, due to the respiratory pattern displayed during this test.My answer was a resounding No.I did inform her I have been an avid diver for many years. Apparently, mechanical ventilation can influence breathing long after a ventilated patient becomes capable to breathe without assistance. It is important to note that these patients are on supplemental O2, up to 100%, based on oxygen requirements. Respiratory rate is set and/or adjusted to promote gas exchange.
I have been a nurse for over 30 years and have seen this pattern/waveform many times. I have never heard of this phenomenon. We all know that breathing influences our buoyancy and gas exchange/consumption. We all should know the number one rule while diving is not to hold one's breath.So finally I pose this question(s):

Has anyone ever heard that diving can "reprogram" the way we breathe out of the water or are we more conscious of our breathing as diver?

Hopefully I did not bore too many people with this long post. I would appreciate any feedback, positive or negative.

 

[Jcp2]

I’m guessing that you breathe normally without a mouthpiece but the test with a mouthpiece stimulates you to breathe as you do underwater.

 

[Ninjapug]

I’m guessing that you breathe normally without a mouthpiece but the test with a mouthpiece stimulates you to breathe as you do underwater.

My thoughts exactly. Thank you for your reply.

 

[rfwoodvt]

Since diving i now breathe more with my diaphragm

 

[happy-diver]

We all should know the number one rule while diving is not to hold one's breath.

Is this full lungs or half full lungs, are you at the end of exhalation, going up or down or not
are you pausing at the end of inhalation, pausing at the end of exhalation, pausing half way

are you doing all of these things whilst controlling your buoyancy and also without realising

 

[Trace Malinowski]

It might also be as simple as we walk differently when someone asks us to walk normally because we are now consciously doing something we normally don't think about doing.

 

[Ninjapug]

Is this full lungs or half full lungs, are you at the end of exhalation, going up or down or not
are you pausing at the end of inhalation, pausing at the end of exhalation, pausing half way

are you doing all of these things whilst controlling your buoyancy and also without realising

When I first started diving I had terrible buoyancy. I knew that breathing was an important part of this so I really started to concentrate. Factor in the amount of bcd adjustment and poor breathing technique, I was emptying my 80 pretty quickly. With time, patience, and experience, buoyancy improved and air consumption decreased. I was no longer wasting my cylinder inflating and dumping my bcd.
We are all told never to hold our breath. I took that too literally. To answer your question about pausing (very, very, briefly) at end expiration and end inhalation the answer is yes. I don’t breath all the way in or out. So no to “full” lungs and no to forceful expiration. I really stopped thinking about it a long time ago. Diving became much more enjoyable. I did have a great deal of help from my dive group. They were all very experienced divers, so a big shout out to them.

 

[Ninjapug]

It might also be as simple as we walk differently when someone asks us to walk normally because we are now consciously doing something we normally don't think about doing.

Great point!

 

[Duke Dive Medicine]

Modern ventilators have visual waveform displays that indicate respiratory patterns. If a patient is completely( no spontaneous respirations) dependent on mechanical ventilation, the pattern is uniform to specific ( Tidal Volume, Rate of Respirations/ Minute, etc). parameters. I recently had a pulmonary function study and was asked to "breathe normally" for 2 minutes. A nose clip was placed and I was instructed to breathe normally, by mouth, into a mouthpiece attached to an analyzer on "Room Air" which is healthcare speak for the air we breath (21% O2, N2 78%). Not to insult anyone's intelligence, but this is the standard mixture of compressed air we all used as students and still use after certification. Some will sacrifice depth for bottom time and use Nitrox or other mixtures after proper certification. The Respiratory Therapist immediately inquired if I been on ventilatory support, long term, due to the respiratory pattern displayed during this test.My answer was a resounding No.I did inform her I have been an avid diver for many years. Apparently, mechanical ventilation can influence breathing long after a ventilated patient becomes capable to breathe without assistance. It is important to note that these patients are on supplemental O2, up to 100%, based on oxygen requirements. Respiratory rate is set and/or adjusted to promote gas exchange.
I have been a nurse for over 30 years and have seen this pattern/waveform many times. I have never heard of this phenomenon. We all know that breathing influences our buoyancy and gas exchange/consumption. We all should know the number one rule while diving is not to hold one's breath.So finally I pose this question(s):

Has anyone ever heard that diving can "reprogram" the way we breathe out of the water or are we more conscious of our breathing as diver?

Hopefully I did not bore too many people with this long post. I would appreciate any feedback, positive or negative.

I'm very interested to hear more about the specific respiratory pattern that the RT noticed. I know you know this, but for readers not familiar with mechanical ventilation, it's a completely different way to breathe. Normal breathing functions using negative pressure: the diaphragm moves down, the abdomen may move out depending on how we breathe, and the intracostal muscles contract, resulting in a negative pressure inside the lungs. Air moves in in response to that pressure gradient. Mechanical ventilation is the complete opposite. Air is forced into the lungs via positive pressure (CPAP users can somewhat relate), which inflates the lungs and, depending on the ventilator settings, requires little to no effort on the part of the individual being ventilated. All sorts of complications can result from this because of the mechanics involved, including deconditioning of the respiratory muscles.

Best regards,
DDM

 

[Ninjapug]

I'm very interested to hear more about the specific respiratory pattern that the RT noticed. I know you know this, but for readers not familiar with mechanical ventilation, it's a completely different way to breathe. Normal breathing functions using negative pressure: the diaphragm moves down, the abdomen may move out depending on how we breathe, and the intracostal muscles contract, resulting in a negative pressure inside the lungs. Air moves in in response to that pressure gradient. Mechanical ventilation is the complete opposite. Air is forced into the lungs via positive pressure (CPAP users can somewhat relate), which inflates the lungs and, depending on the ventilator settings, requires little to no effort on the part of the individual being ventilated. All sorts of complications can result from this because of the mechanics involved, including deconditioning of the respiratory muscles.

Best regards,
DDM

I wish I had requested a copy of the PFT when the RT pointed this out. I will submit a request to obtain this information. On the subject of CPAP, I have been on therapy for 11years. I use a nasal cushion (Philips Dreamwear) -8cm H2O. It is not a BiPAP unit. My AHI is 0.5 on average and average sleep or use time is 7hrs/night. I didn’t go into PEEP or PS in my writing to reduce reader boredom. I will gladly submit the results of my PFT is you so desire. I truly appreciate your interest in this matter.