University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository


Aerospace Medicine


Elyse Watkins



Introduction. The purpose of this short review article is to evaluate the efficiency and efficacy of resting and exercise-enhanced denitrogenation procedures. The procedures involve breathing 100% oxygen before high altitude, low ambient pressure exposures. Treatment considerations specific to altitude-related decompression sickness (DCS) will be examined.

Methods. A PubMed, Ingenta, and AMA Archives literature search with the keywords and phrases; prevention of altitude decompression sickness, denitrogenation, and exercise-enhanced prebreate. The original search yielded seventeen articles, seven of which were used in

preparing the project. One of the articles, a meta-analysis, contained over 100 references from fifty years of decompression sickness research at Brooks Air Force Base.

Results. The evidence from multiple high-quality studies demonstrated the advantages of exercise-enhanced prebreathe over resting prebreathe in the prevention of altitude DCS, as well as treatment considerations other than hyperbaric oxygen. (HBO).

Conclusion. Denitrogenation is crucial in preventing DCS in high altitude aviators. Exercise-enhanced prebreathe is a more effective and efficient procedure to off-gas nitrogen then sedentary prebreathe. The studies reviewed show that an exercise-enhanced prebreathe is better than a resting prebreathe in decreasing the risk of DCS. Cases of altitude DCS may be able to be treated without the need for HBO.

Keywords: Altitude Decompression Sickness, Denitrogenation, Exercise-Enhanced Prebreathe, Ground Level Oxygen, Hyperbaric Oxygen.


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