Do Blood Thinners Increase Risk?

[neilrice]

I have been diving for about 3 years and am also taking a drug called Plavix to keep the arteries flowing nicely. I notice that even a small cut can sometimes bleed much longer now and was curious to know if thinner blood will increase the risk of DCS. I am imagining those little bubbles having an easier time escaping?

 

[Dr Deco]

Hello nealrice :

Blood Thinners

Medications such as these (and aspirin, ibuprofen, etc) retard clotting of the blood and guard against clots forming that could lead to stokes and heart attacks. They are not really blood thinners and do not actually reduce the viscosity ("thin" in a manner similar to adding water to syrup).

DCS

Viscosity changes are said to reduce DCS when they increase the total volume of blood and increase local blood flow (perfusion). Anticoagulants do not increase blood volume. I would not suspect that they reduce the risk of DCS.

Dr Deco :doctor:

 

[Saturation]

I concur with Dr Deco. Just note if you are injured for any reason, an agent like Plavix can worsen the bleeding associated with the injury, which I think you are pre-warned about when taking Plavix or similar drugs. In DCS, where some injury maybe caused by bubble emboli that could cause reducing of blood flow to tissues and then injury, called ischemia, anti-platelet agents can turn ischemic injuries into hemorrhagic ones, or bleeding types, which enlarge and cause more injury. The chance of this occuring depends on the drug, dosage and the type of injury.

http://en.wikipedia.org/wiki/Plavix#Adverse_effects

 

[cutlass]

I also can't think of a reason for which anticoagulants would specifically change DCS risk. Such meds typically affect proteins in the clotting cascades and AFAIK, these aren't associated with gas exchange or solubility in tissues.

OTOH, during a DCS hit or treatment, there may be a coincidental benefit to being on anticoagulants or anti-inflammatories. I'm not on top of the subject but IIRC, although not convincingly proven, anticoagulant or anti-inflammatory agents should reduce clot formations which follow micro-bubble embolic events. Then theoretically, there's a lower potential for thrombotic complications. Of course, this idea in no way recommends routine prophylactic use of any type of anticoagulant or anti-inflammatory. As already noted, there are other bleeding risks with anticoagulants and not only for cuts and scrapes.

 

[neilrice]

I want to thank all of you for your input. I have since done some other research that supports this consensus. I am aware of the increased risk for bleeding, even with minor cuts it is sometimes difficult clot. I have become much more aware of any situation that could cause this injury, I now wear at least thin gloves on any dive.

 

[Saturation]

FYI:

Adjunctive treatment of decompression illness with...[Undersea Hyperb Med. 2003] - PubMed Result

Intramuscular diclofenac sodium as adjuvant therap...[Undersea Biomed Res. 1986] - PubMed Result


How it works maybe early relief of pain, but it doesn't mean better correction of the malady. It applies only to NSAID and possible aspirin agents due to inflammatory properties.

 

[DandyDon]

I want to thank all of you for your input. I have since done some other research that supports this consensus. I am aware of the increased risk for bleeding, even with minor cuts it is sometimes difficult clot. I have become much more aware of any situation that could cause this injury, I now wear at least thin gloves on any dive.

The first week of my treatment for DVT they were giving me shots every day while the coumadin got to working and boy did I bruise easily. I was very careful not to get cut even tho they let me do that week outpatient. I was still on coumadin almost 3 months later for my next dive trip; my home dive buddy knew all about it and went on the trip so I just made sure that the crew were well advised.