Cardiovascular and thermal responses to SCUBA diving

Recreational SCUBA diving exposes individuals to environmental stresses not often encountered in other types of activity. These stresses include increased ambient pressure, raised partial pressure of O(2), increased resistance to movement, added weight and drag of diving equipment, cold stress, and a higher breathing resistance. One means to understand how such stresses affect a diver is to employ the stress-strain-adaptive response model. Physiologic adaptations, like an increase in VO(2) in response to cold stress, will minimize the strain placed on thermal balance. Nonphysiologic adaptive responses include those behavioral and equipment interventions that isolate the diver from a particular stress. Self-contained underwater breathing apparatus (SCUBA) isolates the diver from the inability to extract O(2) from the water; dive garments minimize the stress of cold water immersion. This review will focus on cardiorespiratory and thermal responses to SCUBA diving, using the stress-strain-adaptive response model to illustrate the interaction between diver and environment. Some responses like hyperventilation, cardiac arrhythmias, or cold injury due to vasoconstriction are not considered adaptive but are realistic possibilities in diving environments.