Maintaining Your Respiratory Reserve

The following is a reprint from InDepth: Digital Scuba Diving Magazine by Global Underwater Explorers.

Published on September 6, 2019             By InDepth

by John Clarke

JJ on his JJ.” Photo by Andreas Hagberg.

Just like skeletal muscles, respiratory muscles have a limited ability to respond to respiratory loads. An excellent example of this is a person’s inability to breathe through an overly long snorkel (Figure 1.) Our respiratory muscles simply aren’t strong enough to overcome the pressure difference between water depth and the surface.

This doesn’t work. Her respiratory muscles are not strong enough.
Illustration by Cameron Cottrill.

The primary respiratory muscle is the diaphragm, (the brown organ lying below the lungs in Figure 2.) The diaphragm is designed for low-intensity work maintained 24/7 for the entirety of your life.

Like the heart muscle, its specialty is endurance. When called upon to maximally perform,  the diaphragm needs assistance.

That assistance is provided by the accessory respiratory muscles, primarily the intercostal muscles linking the ribs within the rib cage.

The human diaphragm separating the lungs from the abdominal cavity. Graphic by John Clarke.

Unless you’re reading this while running on a treadmill, your body is probably idling. Your heart is beating rhythmically, your diaphragm is methodically contracting and relaxing. But, if some dire event were to happen, you would be primed for action. If you needed to react to an emergency, your heart and lungs would race at full speed.

The difference between idling and full-speed capability is called physiological reserve, which in turn is divided into its components; cardiac, muscular, and ventilatory reserve. As drivers, pilots, and boat captains will attest, it’s always good to have fuel reserves. Likewise, physiological reserve is good to have in abundance.

The Dive

The following is an imaginary tale of a young, blond-haired hipster drawn to the Red Sea for a deep dive. He chose to dive on the wall at Ras Mohammed on the Eastern Shore of the Sinai, which descends quickly down to a thousand feet and beyond. That was his target—1,000 feet.

The previous year he bought a rebreather so gas usage should not be a problem for his deep dive. He also sprang for the cost of helium-oxygen diluent. Trimix would have been cheaper, but he spared no expense. Nothing but the best. To that end, he used loose-fill, fine grain Sodalime in his CO2 scrubber canister.

These were his thoughts as he descended.

Free-falling at three hundred feet. Never been this deep before. The water’s getting cold, so the warm gas from the canister feels good.

800 feet. Wow, the gas is thicker now.

When he reached the bottom, he realized something wasn’t right. He sucked harder and harder, feeling his full face mask collapsing around his face with each inhalation. He was “sucking rubber,” feeling like he was running out of gas, but his diluent pressure gage still read 1800 psi.

Unconsciously, he compensated for the respiratory load by slowing his breathing—easing his discomfort. Concerned, he briefly switched to open circuit bailout gas, but that didn’t feel any better. In fact, it was worse, so he switched back to the bag.

Surprisingly, he couldn’t get off the bottom. In fact, he was slipping further downslope. He needed to drop weights, but they were integrated. He fumbled with his vest, trying to remember how to release the weights, but he couldn’t work it out.

He found the pony bottle to inflate his integrated BC, but after a second’s spit of air, it stopped filling. He would have to swim off the bottom. As he struggled to swim upwards in the darkness, and without bubbles to guide him, he wasn’t sure which way was up.

His heart was beating at its maximum rate, trying to force blood through his lungs, but he couldn’t force enough gas in and out of his lungs to clear his bloodstream of its increasingly toxic CO2 load. The build-up of CO2 in the arterial blood was clouding his thinking. The CO2 was making him want to breathe harder, but he couldn’t. The feeling of breathlessness—and impending doom—was overwhelming.

————

The accident investigation on the equipment was inconclusive. The dive computer had flooded, but that was irrelevant. Surface pre-dive checks were passed. The rebreather seemed to function normally when tested in a swimming pool. The investigators convinced a Navy laboratory to press the rebreather down to 1,000 feet, but nothing abnormal was found other than a slight elevation of controlled PO2.

The Analysis

An asthma attack can kill by narrowing the airways in the lung, making the person suffering the attack feel like they’re sucking air through a clogged straw.

A healthy diver doesn’t have airways that constrict, but gas density increases with depth, causing the same effect as a narrowed airway. It becomes increasingly difficult to breathe as depth increases. A previous InDepth blog post on gas density discusses this subject.

Normal human airways compared to airways during an asthma attack. Graphic courtesy of Asthma and Allergy Foundation of America.

If the strength of respiratory muscles is finite, just as it is for all muscles, then any load placed on those muscles will eat away a diver’s “respiratory reserve.” From the diaphragm’s perspective, the total loading it encounters is divided between that internal to the diver and that external to the diver. As gas density increases, internal loading increases. A rebreather is external to the body, so flow resistance through a rebreather adds to the total load placed on the respiratory muscles. If the internal resistance load increases a lot, as it does at great depth, there is very little reserve left for external resistance, like that of a rebreather.

In this fictional tale of a hapless diver, he needlessly added respiratory resistance by using fine-grain Sodalime in his scrubber canister. Compared to large grain Sodalime, such as Sofnolime 408, fine-grain absorbent adds scrubber duration, but it also increases breathing resistance. It thus cut into the diver’s ventilatory reserve.

This fictional diver exceeded his physiological reserves by,

  1. not understanding the effect of dense gas on the “work of breathing,”
  2. not understanding the limitation of his respiratory muscles, and
  3. by not realizing the “best” Sodalime for dive duration was not the best for breathing resistance.

He also didn’t realize that a rebreather scrubber might remove all CO2 from the expired gas passing through it, but it is ventilation (breathing) that eliminates the body’s CO2 from the diver’s bloodstream. Once CO2 intoxication begins, cognitive and muscular ability quickly decline to the point where self-rescue may be impossible.

Lessons from The U.S. Navy

Considering the seriousness of the topic, it is worthwhile to review the following figures prepared for the U.S. Navy.

First, we define peak-to-peak mouth pressure, a measure of the pressure exerted by a working diver breathing through the external resistance of a rebreather. Total respiratory resistance for a diver comes in two parts: internal and external. In the following figures, those resistances in the upper airways are symbolized by a small opening, and in the external breathing apparatus, by a long, narrow opening representing a UBA attached to the diver’s mouth.

High external resistance. In this case, the difference between mouth pressure and ambient water pressure is called ΔP1 Credit with modifcation: “Direct measurement of pressures involved in vocal exercises using semi-occluded vocal tracts”.
Low external resistance. The difference between mouth pressure and ambient water pressure is called ΔP2. Credit with modification: “Direct measurement of pressures involved in vocal exercises using semi-occluded vocal tracts”.
Mouth pressure waveforms ΔP1 and ΔP2 during breathing with high (P1) and low (P2) external resistance.

This author reviewed over 250 dives by Navy divers at the Naval Medical Research Institute and the Navy Experimental Diving Unit. These were working dives involving strenuous exercise at simulated depths down to 1500 feet seawater, using gas mixtures ranging from air to nitrox and heliox. Gas densities ranged from about 1 gram per liter (g/L) (air at the surface) to over 8 g/L. Each dive was composed of a team of divers, so each plotted data point had more than one man-dive result included. An “eventful” dive was one where a diver stopped work due to loss of consciousness, or respiratory distress (“dyspnea” in medical terminology.) They were marked as red in the following figure. Uneventful dives were marked in black.

Using a statistical technique called maximum likelihood, the data revealed a sloping line marking a boundary between eventful and uneventful dives.

Peak-to-peak mouth pressure and gas density conspire to increase a diver’s risk of an “event” during a dive.

The fact that the zero-incidence line sloped downward illustrates the fact that the higher the gas density, the greater the respiratory load imposed on a diver by both internal and external (UBA) resistance. The higher that load, the lower the diver’s tolerance to high respiratory pressures.

By measuring peak-to-peak mouth pressures, we are witnessing the effect of UBA flow resistance at high workloads. It does not reveal the flow resistance internal to the body. However, when gas density increases, internal resistance must also increase.

The interrupted lines in the figure illustrate lines of estimated equal probability of an event. The higher the peak-to- peak pressure for a given gas density, the higher the probability of an eventful dive.

Figure 7 suggests that at a gas density of over 8 grams per liter, practical work would be impossible. The only way to make it possible would be to reduce gas density by substituting helium for nitrogen, or substituting hydrogen for helium, and then doing as little work as possible to keep ΔP low.

For our fictional 1,000 foot diver, the gas density would have been between 6 and 7 grams per L. Using a rebreather, there would be virtually no physiological reserve at the bottom. Moderate work against the high breathing resistance at depth would be very likely to result in an “eventful” dive.

Image Citation for medical graphics: Robieux C, Galant C, Lagier A, Legou T, Giovanni A. Direct measurement of pressures involved in vocal exercises using semi-occluded vocal tracts. Logoped Phoniatr Vocol. 2015 Oct;40(3):106-12. doi: 10.3109/14015439.2014.902496. Epub 2014 May 21. PMID: 24850270.

John Clarke, also known as John R. Clarke, Ph.D., is a Navy diving researcher in physiology and physical science. Clarke was an early graduate of the Navy’s Scientist in the Sea Program. During his forty-year government career, he conducted physiological research on numerous experimental saturation dives. Two dives were to a pressure equivalent to 1500 fsw.

For twenty- eight years he was the Scientific Director of the Navy Experimental Diving Unit.

Clarke has authored a technothriller-science fiction series called the Jason Parker Trilogy. All three volumes, Middle Waters, Triangle, and Atmosphere, feature saturation diving from depths of 100 feet to 2,500 feet. The deepest dives involve hydreliox, a mixture of helium, hydrogen and oxygen. UFOs, aliens, and an uncaring cosmos lay the framework for political and human intrigue both on and off-planet.

Although now retired, Clarke has worked for NEDU as a Scientist Emeritus. He now runs a consulting company, Clarke Life Support Consulting, LLC. He helps various companies, when he isn’t writing about diving, aviation, and space. His websites are www.johnclarkeonline.com and www.jasonparkertrilogy.com. His thriller series is available at Amazon and Barnes & Noble.

Related Blog Posts – Further Reading for Rebreather Divers

How Does Your Rebreather Scrubber Handle the Deep?

If you’ve planned a deep dive, to say 100 meters or deeper, you may have wondered just how your rebreather scrubber will handle that depth. Since pressure is equalized across a carbon dioxide (CO2absorbent canister within a rebreather, it won’t implode. But what about the chemical absorption reactions occurring within the scrubber?

The rebreather scrubber is a vital part of your underwater life support system, so that question is a pretty important one. And the answer is very hard to find.

I recently traveled to Ireland to act as an external examiner for a Ph.D. student’s Doctoral Dissertation defense in the Department of Mechanical, Biomedical and Manufacturing Engineering of the Cork Institute of Technology. The very talented graduate student was Shona Cunningham, and her dissertation was titled, “Carbon Dioxide Absorption and Channeling in Closed Circuit Rebreather Scrubbers”. She’s an athlete, musician, and perhaps most importantly for you readers, an avid diver.

CaptureHer work is the first computational fluid dynamic representation of scrubber canister thermokinetics. A portion of her dissertation work has already been published. Apparently it was partially inspired by some of my computer simulation descriptions posted on this blog, which can be found here, here and here.

Dr. Cunningham’s analytical approach (using Ansys CFX) showed that ambient pressure (depth) could reduce the effectiveness of scrubber canisters. In support of that finding were the words from the Dive Gear Express web site regarding the Diverite O2ptima using the ExtendAir scrubber cartridge.

“As pressure increases the total number of molecules, the relative concentration of CO2 molecules in the loop is reduced, slowing the chemical absorption process. Thus as depth increases, scrubber efficiency will decrease.”

The U.S. Navy has no experience with the Diverite O2ptima, but they have information on other rebreathers using granular absorbent. That experience shows that there is no reliable depth effect across all rebreathers and all absorbents.

U.S. Navy MK 16. US Navy photo by Bernie Campoli.

For example, in one rebreather there was indeed a 17% decrease in endurance using large grain absorbent (Sofnolime 408) at 50°F in descending from 190 fsw to 300 fsw (58 to 92 msw) breathing air. However, there was no decrease in duration when using fine grain absorbent (Sofnolime 812) under the same conditions. (On an actual dive, air would never be used at 300 fsw, but air was used in this study for scientific reasons.)

In another rebreather using Sofnolime 812, for a change in depth from 99 fsw to 300 fsw (30.3 to 92 msw) there was a 29% increase in duration at 75°F, a 10% increase at 55°F, and a 15% decrease at 40°F. Although air diluent was used at 99 fsw, 88/12 heliox diluent was used at 300 fsw.

From another manufacturer I obtained information on two of their rebreathers. At 4°C, 1.6 L/min CO2 injection rate (corresponding to a fairly heavy work rate), 40 L/min ventilation rate using air diluent, there was a 27% decrease in one rebreather in going from 15 to 40 msw (50 fsw to 132 fsw), and a 11% decrease in another of their rebreathers in dropping from 40 msw to 100 msw.

In another rebreather tested under the same conditions except depth, the canister duration dropped 39% between 15 and 40 msw.

So, there is some support for a drop in duration with depth, but in other cases there is either no effect or an increase in duration with deeper depths. Clearly, if the high number of inert gas molecules coming with a pressure increase makes it more difficult for CO2 to reach absorption sites, then that would be a simple and unavoidable fact of physics. But that cannot be the whole story. What is likely to be going on, a hypothesis, is being developed for a later posting.

Should the effect of depth on your particular rebreather matter to you? Logically it shouldn’t. Even on a deep dive, the majority of the dive time is spent shallow, decompressing.

However, consider the case where you conduct a deep dive with an anticipated short bottom time, but something bad happens on the bottom. You or your dive team becomes fouled, ensnared in lines. Or there is a a partial cave collapse trapping you. The benefit of a rebreather over scuba is that it gives you time to sort out your problem. Gas consumption is not nearly as great a concern as with open circuit breathing apparatus.

However, as the minutes tick by as you work deep to get yourself or a team member free,  you might wonder, “How is my scrubber handling this depth?” In the middle of a crisis is no time to be making assumptions about the status of a major part of your life support system.

Ask your manufacturer how your canister performs at depth.  You have a right to know, and that information just might prove useful some day.

 

Keep Your Powder Dry, Rebreather Divers

Compared to decompression computers, digital oxygen control, and fuel cell oxygen sensors, carbon dioxide absorbent is low tech and not at all sexy. Perhaps because it is low in diver interest, it is poorly understood. In rebreather diving, a lack of knowledge is dangerous.

The U.S. Navy Experimental Diving Unit (NEDU) is intimately familiar with sodalime, the crystalline carbon dioxide absorbent used in a wide variety of self-contained breathing apparatus for both diving and land use. NEDU routinely tests sodalime during accident investigations, during CO2 scrubber canister duration determinations, or during various research and development tasks. They have developed computer models of scrubber canister kinetics, and patented and licensed technology for use in determining how long a scrubber will last in diving and land applications.

The types of sodalime in NEDU’s experimental inventory are:  Sodasorb_rotate

  1. Sofnolime 408 Mesh NI L Grade
  2. Sofnolime 812 Mesh NI D Grade
  3. HP Sodasorb (4/8 Reg HP)
  4. Dragersorb 400
  5. Limepak
  6. Micropore

Absorbent undergoes a battery of quality tests at NEDU, most of them in accordance with NATO standardized testing procedures (STANAG 1411). One test is of the distribution of sodalime granule sizes, and another tests the softness or friability of the granules. One test checks the moisture content of the sample, and another tests the CO2 absorption ability of a small sample of absorbent.

From time to time, absorbent lot samples fail one or more of these tests. One failure of granule size distribution was caused by changes in production procedures. “Worms” of absorbent rather than granules of absorbent started showing up in sodalime pails. In another case, absorbent was found to have substandard absorption activity, and in yet another, the material was too soft. Too soft or friable material  can allow granules to breakdown, turning into dust.

This would not be a major problem, except that a diver or miner has to breathe through his granular absorbent bed, and dust clogs that bed, making breathing difficult. In the extreme, labored breathing from unusually high dust loading can result in unconsciousness.

Bag of granules_rotate
Sample bags of sodalime removed from absorbent buckets, awaiting testing.

What does the above have to do with this post’s title?

Supposedly, the maxim “Trust in God, but keep your powder dry” was uttered by Oliver Cromwell, but  first appeared in 1834 in the poem “Oliver’s Advice” by William Blacker with the words “Put your trust in God, my boys, and keep your powder dry!” If indeed Cromwell did say it, then it dates from the 1600’s.

A much more modern interpretation, appropriate for rebreather divers, is as follows: buckets of sodalime with a larger than usual layer of dust at the bottom (due to the mechanical breakdown of absorbent granules during shipment), should be kept dry. In other words, don’t dive it!

Picture12
Micropore rolled carbon dioxide absorbent on the right, granular absorbent on the left.

Presumably this is not an issue with Micropore ExtendAir CO2 absorbent since it’s basically sodalime powder suspended on a plastic medium. The diver breathes through fixed channels in the ExtendAir cartridge, not through the powder.

Considering the relatively high cost of granular sodalime, a diver might be very reluctant to discard an entire bucket of absorbent with a non-quantifiable amount of dusting. They certainly will not be performing sieve tests for granule size distributions like NEDU, however one simple solution to a suspected dusting problem might be to sieve the material before diving it. The only requirement would be that only the dust should be discarded, not whole granules. In other words, your sieve must have a  fine mesh.

In NEDU’s experience, quality control issues are not necessarily a problem with manufacturing. Where and how sodalime is stored can apparently have an appreciable effect on sodalime hardness.  The same lot of sodalime stored in two different but close proximity locations has been found to differ markedly in its friability. Exactly why that should be, is presently unknown.

Regardless of whether the subject is sexy or not, a wise rebreather diver will seek all the knowledge available for his “sorb”, as it’s sometime called. After all, the coolest decompression computer in the world will do you no good at all if you’re unconscious on the bottom because you tried to outlast your CO2 absorbent.

 

 

 

 

 

 

In Diving, What is Best is Not Always Good

A Closed Circuit Rebreather diver in a Florida spring.

In technical or recreational rebreather diving, safety is a matter of personal choice. Wrong choices can turn deadly.

Some poor choices are made for expediency, while others are made with the best of intentions but based on faulty or incomplete information. As a diving professional, it is those latter choices that concern me the most.

David Shaw

A poignant and well documented diving fatality involved a record setting Australian diver, David Shaw. David was an Air Bus pilot for Cathay Pacific.

Professional pilots are immersed in a culture of safety, a culture that makes airline travel the surest means of long distance transport. David applied that same sort of attention to his diving, recording on his personal web site his detailed plans for a record setting dive to recover the body of a diver who died in the 890 feet (271 meter) deep Boemansgat Cave of South Africa 10-years prior to David’s ill-fated dive.

Despite his extensive preparations, David Shaw made a fatal mistake. Like those who fail to appreciate the threat of an approaching hurricane, David failed to recognize the risk of really deep diving with a rebreather.

Unlike other types of underwater breathing equipment, a rebreather is entirely breath powered. That means you must force gas entirely through the “breathing loop” with the power of your respiratory muscles. On a dive to 890 feet, you are exposed to 28 times normal pressure, and breathing gas more than five times denser than normal. The effort involved is enough to dismay some U.S. Navy divers at depths far less than David Shaw intended to dive. Yet in David’s own words, he had previously never had a problem with the effort of breathing.

“The Mk15.5 (rebreather) breathes beautifully at any depth. WOB (work of breathing) has never been an issue for me. Remember that when at extreme depth I am breathing a very high helium mixture though, which will reduce the gas density problem to a certain extent.”

He goes on to say, “I always use the best quality, fine-grained absorbent on major dives. The extra expense is worth it.”

“I have had 9:40 (9 hrs, 40 min duration) out of the canister and felt it still had more time available, but one needs to qualify that statement with a few other facts. Most of the time on a big dive I am laying quietly on deco (decompression), producing minimal CO2 (carbon dioxide).

In those words lie a prescription for disaster.

A rebreather scrubber canister containing granular absorbent through which a diver has to breathe.

David wanted to use a single rebreather that would accomplish two tasks — provide a long duration gas supply and CO2 absorbing capability for a dive lasting over nine hours, and provide a low work of breathing so he could ventilate adequately at the deepest depth. To ensure the “scrubber canister” would last as long as possible, he chose the finest grain size, most expensive sodalime available. His thought was, that was the best available.

Arguably, the two aims are incompatible. He could not have both a long duration sodalime fill and low breathing resistance.

Cartoon of breathing through a scrubber canister.

As illustrated in a previous blog posting, the smaller the size of granules you’re breathing through, the harder it is to breathe. Think of breathing through a child’s ball pit versus breathing through sand.

Perhaps if David had maintained a resting work rate throughout the deepest portion of his fatal dive, he might have had a chance of survival. After all, he had done it before.

But the unexpected happens. He became fouled and was working far harder to maintain control of the situation than he had anticipated. That meant his need to ventilate, to blow off carbon dioxide from his body, increased precipitously.

A sure sign of high breathing effort is that you cannot ventilate as much as is necessary to keep a safe level of carbon dioxide in your blood stream. CO2, which is highly toxic, can build rapidly in your blood, soon leading to unconsciousness. From the videotaped record, that is exactly what happened.

Purer A, Deason GA, Hammonds BH, Nuckols ML. The effects of pressure and particle size on CO2 absorption characteristics of High-Performance Sodasorb. Naval Coastal Systems Center Tech. Manual 349-82, 1982. (Click for larger image.)

Had David been fully aware of the insidious nature of carbon dioxide intoxication from under breathing (hypoventilating), he probably would have chosen an alternative method to conduct the dive.

One alternative would be to use a larger granule size absorbent in a rebreather at considerable depth (say, 100 meters and deeper), and reserve the fine-grain absorbent for use in a separate rebreather shallower than 100 meters.

David chose the fine-grain absorbent because of the longer dive duration it made possible. Although fine grains are more difficult to breathe through than large grain absorbent, fine grain absorbent lasts longer than large grain absorbent.

But that long duration is only needed during decompression which is accomplished far shallower than the deep portions of the dive. The time spent deep where work of breathing is a threat is quite short. He did not need the capabilities of a long duration, fine grain absorbent.

From the U.S. Navy experience, there are other problems with this dive which might have hastened the end result. A rapid and deep descent causes the oxygen pressure within the rebreather to climb to potentially dangerous levels; a phenomenon called oxygen overshoot. Thus he might have been affected somewhat by oxygen toxicity. A rapid descent might also have induced the High Pressure Nervous Syndrome which would affect manual dexterity.

While those contributing factors are speculative and not evident on the tape, the certainty of the physics of dense gas flow through granular chemical absorbent beds is an unavoidable fact.

No doubt, many have offered opinions on what caused David’s accident. I certainly do not claim to be intimately involved in all the details, nor familiar with all the theories offered to date. Nevertheless, David’s mistaken belief that using the “best absorbent” was the best thing for his dive, is a mistake that needs to be explained and communicated before this accident is repeated with a different diver in some other deep and dark place.

Click to go to the source document.