Evidence map›Paper›PMID 40986922›Full record

GuidelineDiving and hyperbaric medicine2025

Revised guideline for central nervous system oxygen toxicity exposure limits when using an inspired PO2 of 1.3 atmospheres.

Joseph T Hoyt, F Gregory Murphy, Neal W Pollock, Dawn Kernagis, Nicholas Bird, Michael Menduno, John Bright, Simon J Mitchell

Abstract readGuideline
In one paragraph

Guideline in Diving and hyperbaric medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Joseph T HoytNOAA Diving Program, National Oceanographic and Atmospheric Administration, Seattle, WA, USA.
F Gregory MurphyNavy Experimental Diving Unit, Panama City, FL, USA.
Neal W PollockDepartment of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada.
Dawn KernagisDEEP Research Inc., Miami, FL, USA.
Nicholas BirdDepartment of Hyperbaric Medicine, Virginia Mason Hospital, Seattle, WA, USA.
Michael MendunoInDEPTH Magazine, High Springs, FL, USA.
John BrightCPC Inc., San Diego, CA, USA.
Simon J MitchellDepartment of Anaesthesiology, University of Auckland, Auckland, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Technical and scientific divers breathing gases delivering hyperbaric pressures of inspired oxygen may be at risk of developing cerebral oxygen toxicity which can manifest as a seizure with little or no warning. The principle preventative strategy is adherence to time limits based on inspired PO₂ levels promulgated in 1991. These limits had their origins in US Navy studies of exposures to higher inspired PO₂s than are typically utilised by modern divers. Indeed, the duration limits for inspired PO₂s in the range typically utilised by technical divers (≤ 1.3-1.4 atm) have relatively little experimental provenance. Contemporary technical dives often involve decompression durations that result in breaches of these limits, and anecdotally, this common occurrence seems associated with a low risk of cerebral oxygen toxicity. A committee of experts recently sought experimental evidence that might support an adjustment to the recommended duration limits for typical technical dives. Such evidence exists only for an inspired PO₂ of 1.3 atm, which is a common default in use of constant PO₂ rebreather devices. The (1991) limit for a single exposure to an inspire PO₂ of 1.3 atm is 180 min with a 24-hour maximum of 210 min. Recent studies provide reassurance that dives with an inspired PO₂ of 1.3 atm consisting of up to 240 min of working dive activity followed by up to 240 min of resting decompression are associated with an acceptably low risk of cerebral oxygen toxicity. This recommendation was promulgated and endorsed at a recent workshop convened by the National Oceanographic and Atmospheric Administration (NOAA) involving technical and scientific divers.

Indexed as

Decompression SicknessDivingHyperbaric OxygenationOxygenHumansPartial PressureTime FactorsOxygenOxygen clockRebreathersRiskSeizuresTechnical diving

Identifiers

PMID40986922
PMCPMC12500339

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.