{
  "abstract": "Introduction\n\nThis paper is a narrative review and theoretical perspective presenting principles, concepts, and perspectives for improving decompression procedures. It distinguishes three levels of evidence: established observations, hypotheses with experimental support, and mechanistic scenarios that remain hypothetical.Methods\n\nWe organize decompression around two linked dimensions: bubbles as the primary physical event and microparticles (MPs) as a physiological consequence. We hypothesize that a substantial proportion of decompression-related microbubbles originate from pre-existing gas micronuclei associated with active hydrophobic sites (AHS) at three locations: distal arterial, venous, and extravascular. From these assumptions, five bubble scenarios are considered: growth and detachment from distal arterial AHS; growth and detachment from venous AHS; pulmonary bubble filtration; survival of arterial gas microbubbles and their potential target organs; and intravascular bubble development. Physiological factors may generate MPs, endothelial dysfunction, systemic inflammation, and possibly a secondary generation of microbubbles.Results and discussion\n\nThe proposed scenarios align with decompression sickness (DCS) pathophysiology across five target organ systems: skin, brain, inner ear, spinal cord, and musculoskeletal tissue. Inflammatory stress appears important for defining post-dive intervals and multiday diving patterns. Designing decompression procedures therefore requires integrating individual variability and dive history; dive characteristics such as rapid ascents, yo-yo diving, and surface decompression; the bubble scenarios triggered during ascent; and accumulated oxidative stress, oxy-inflammation, and endothelial damage that modify susceptibility to DCS.Conclusion\n\nThere is no single ultimate decompression algorithm; rather, different strategies reflect different experience, assumptions, and operational contexts.",
  "abstract_shown": true,
  "affiliations": [
    "Environmental and Occupational, Physiology Laboratory, Haute Ecole Bruxelles-Brabant (HE2B), Brussels, Belgium.",
    "The Israel Naval Medical Institute, Haifa, Israel.",
    "Eliachar Research Laboratory, Western Galilee Medical Center, Nahariya, Israel.",
    "Europe Research Division, Divers Alert Network (DAN), Brussels, Belgium.",
    "Europe Research Division, Divers Alert Network (DAN), Roseto, Italy."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jean-Pierre Imbert"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Ran Arieli"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Costantino Balestra"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/17fny721zhnx8.bib",
  "cited_by": 0,
  "doi": "10.3389/fphys.2026.1943519",
  "fulltext_url": "https://europepmc.org/articles/PMC13684882",
  "id": "17fny721zhnx8",
  "issns": [
    "1664-042X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42909981",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Cardiovascular and Diving-Related Complications"
    ]
  ],
  "openalex": "W7220845802",
  "pdf_url": "https://europepmc.org/articles/PMC13684882?pdf=render",
  "pmcid": "PMC13684882",
  "pmid": "42909981",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/17fny721zhnx8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:14Z",
      "native_id": "MED:42909981",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42909981"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Cardiovascular and Diving-Related Complications",
      "subfield": "general"
    }
  ],
  "title": "Principles, concepts, and perspectives for the improvement of decompression procedures: a Neo-Haldanian approach bridging bubble physics and decompression physiology.",
  "title_text": "Principles, concepts, and perspectives for the improvement of decompression procedures: a Neo-Haldanian approach bridging bubble physics and decompression physiology.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:14Z",
  "url": "https://research.draconitic.com/paper/17fny721zhnx8",
  "venue": "Frontiers in physiology",
  "versions": []
}