TAKE A BREATH AT A DEPTH

THE PHYSICS AND PHYSIOLOGY OF NITROGEN NARCOSIS

Mohammed Safwan, Navya Shree Vedachala,Nidhi Satish, Nishant DM

BMS College of Engineering, Bull Temple Road, Basavanagudi, Bangalore-560049.

Abstract: W​ ith the popularity of diving on the increase and deep inland dive sites becoming
more accessible, it is important that we understand the effects of breathing pressurised gas at
depths can have on the body. Narcosis is one of these effects and is a subject that is still being
understood. In extreme cases, it has been shown to contribute directly to up to 6% of deaths in
divers. In other cases, it can cause severe symptoms of confusion, hallucinations and disturbed
coordination which are often reversible, but long term effects have not been ruled out as
research on them is still underway. This article explores the of role of mass transfer in
understanding it better and the proposed physiological mechanisms. This is important in
making diving safe as well as for exploring diffusion mechanisms of anaesthetic gases.

1.INTRODUCTION: physical and mental disturbance,both

Exposure to the underwater environment
poses many challenges on the human
body including thermal stress,
barotraumas, decompression sickness as
well as the acute effects of breathing
gases under pressure. In this report, we
focus on ​the phenomenon of anarcosis
associated with nitrogen. ​Derived from
narke, it produces a state similar to
alcohol intoxication and ​it is more than a
hundred years since the first report in
print of the problem that has been facing
divers ever since their descents went
deeper than 100 feet or the ambient
pressure increased above 4
atmosphere-nitrogen narcosis.
​Also known as raptures of the deep and
Martini effect, inert gas narcosis is a
reversible alteration in ​consciousness
that occurs while ​diving​ at depth.​It is the
subjective and objective, that occurs
when breathing mixtures containing
certain members of inert gases under
pressure. The include
krypton,argon,xenon,nitrogen and
possibly neon.
This report focuses on nitrogen in
particular and under pressure,it can
impede mental function and physical
performance with symptoms as depth
increases.
2.CONSEQUENCES:
To appreciate and apprehend the severity
of the condition, the signs and symptoms
of nitrogen narcosis with increased
partial pressure of Nitrogen can be
summed up as indicated in the Table 1.
Lippmann J, Mitchell S. Nitrogen narcosis, deeper into diving. 2nd ed. Victoria: J.L.
Publications; 2005.
3.MASS TRANSFER CONCEPTS TO
APPRECIATE MECHANISM :
3.1.1.​Diffusion
Diffusion is the movement of molecules or
ions in a medium when there is no gross
mass flow of the medium, and can occur
in gases, liquids or solids, or any
combination.​ ​Diffusion is driven by the
kinetic energy of the diffusing molecules –
it is faster in gases and slower in solids
when compared with liquids due to the
variation in distance between collisions,
and diffusion is faster when the
temperature is higher as the average
energy of the molecules is greater.
Diffusion is also faster in smaller, lighter
molecules of which helium is the extreme
example. Diffusivity of helium is 2.65
times faster than nitrogen.
The partial pressure gradient, also known
as the ​concentration gradient​, can be used
as a model for the driving mechanism of
diffusion. The partial pressure gradient is
the variation of partial pressure (or more
accurately, the concentration) of the
solute (dissolved gas) from one point to
another in the solvent. The solute
molecules will randomly collide with the
other molecules present, and tend over
time to spread out until the distribution is
statistically uniform. This has the effect
that molecules will diffuse from regions of
higher concentration (partial pressure) to
regions of lower concentration, and the
rate of diffusion is proportional to the
rate of change of the concentration.
Tissues in which an inert gas is more
soluble will eventually develop a higher
dissolved gas content than tissues where
the gas is less soluble.
3.1.2. ​Solubility
Solubility is the property of the solute to
be held homogeneously dispersed as
molecules or ions in a liquid or solid
medium the solvent. ]​
3.1.3.Inert gas uptake
In this context, inert gas refers to a gas
which is not ​metabolically active​.
Atmospheric ​nitrogen​ (N​2​) is the most
common example, and ​helium​ (He) is the
other inert gas commonly used in
breathing mixtures for divers​.
Atmospheric nitrogen has a partial
pressure of approximately 0.78 bar at sea
level. Air in the ​alveoli​ of the lungs is
diluted by saturated ​water vapour​ (H​2​O)
and ​carbon dioxide​ (CO​2​), a ​metabolic
product​ given off by the blood, and
contains less ​oxygen​ (O​2​) than
atmospheric air as some of it is taken up
by the blood for metabolic use. The
resulting partial pressure of nitrogen is
about 0,758 bar.
Body tissues include aqueous and lipid
components in varying ratios, and the
solubility of the gases involved in
decompression in these tissues will vary
depending on their composition.
At atmospheric pressure the body ​tissues
are therefore normally saturated with
nitrogen at 0.758 bar (569 mmHg). At
increased ambient ​pressures due to depth
or ​habitat pressurisation​, a diver's lungs
are filled with breathing gas at the
increased pressure, and the partial
pressures of the constituent gases will be
increased proportionally.
The inert gases from the breathing gas in
the lungs diffuse into blood in the ​alveolar
capillaries​ ("move down the pressure
gradient") and are distributed around the
body by the ​systemic circulation​ in the
process known as perfusion.
3.1.4.Perfusion
Perfusion​ is the mass flow of blood
through the tissues. Dissolved materials
are transported in the blood much faster
than they would be distributed by
diffusion alone (order of minutes
compared to hours).
The dissolved gas in the alveolar blood is
transported to the body tissues by the
blood circulation. There it diffuses
through the cell membranes and into the
tissues, where it may eventually reach
equilibrium. The greater the blood supply
to a tissue, the faster it will reach
equilibrium with gas at the new partial
pressure.
3.1.5.Saturation and supersaturation
If the supply of gas to a solvent is
unlimited, the gas will diffuse into the
solvent until there is so much dissolved
that equilibrium is reached and the
amount diffusing back out is equal to the
amount diffusing in. This is called
saturation​.
If the external partial pressure of the gas
(in the lungs) is then reduced, more gas
will diffuse out of the tissues than in. This
is a condition known as ​supersaturation​.
The gas will not necessarily form bubbles
in the solvent at this stage, but
supersaturation is necessary for bubble
growth. A supersaturated solution of
gases in a tissue may form bubbles if
suitable nucleation sites exist.
Supersaturation may be defined as a sum
of all gas partial pressures in the liquid
which exceeds the ambient pressure in
the liquid.
3.1.6 Henry’s law
As you descend on a dive, the increased
pressure causes the volume of air in your
lungs to decrease. But as this happens, the
partial pressure of the air inside your
lungs increases. This means that there is a
greater concentration of nitrogen and
other gases in our lungs than there is in
the blood. It is explained in Henry’s Law:
“At a constant temperature, the amount of
a given gas that dissolves in a given type
and volume of liquid is directly
proportional to the partial pressure of
that gas in equilibrium with that liquid.”
3.1.7.Interphase Mass Transfer
When a component (in this case nitrogen)
mass transports from one phase to
another, this process is called interphase
mass transfer. Many physical situations
occur in nature where two phases (water
and lipid or blood and lipid tissues) are in
contact, and the phases are separated by
an interface. Like single-phase transport,
the concentration gradient of the
transporting species (in this case in both
phases) influences the overall rate of
mass transport. More precisely, transport
between two phases requires a departure
from equilibrium, and the equilibrium of
the transporting species at the interface is
of principal concern. When a multiphase
system is at equilibrium, no mass transfer
will occur. When a system is not at
equilibrium, mass transfer will occur in
such a manner as to move the system
toward equilibrium.
3.1.8.Crysallisation
Crystallization is also a chemical
solid–liquid separation technique, in
which mass transfer of a solute from the
liquid solution to a pure solid crystalline
phase occurs. ​In order to clarify the
phenomenon of crystal growth from an
aqueous solution let us assume that such
a process consists of several consecutive
steps (I) transfer of the solvated Ions
(particles) of solute from the bulk
solution to the proximity of the crystal
surface. (II) adsorption of the solvated
ions (particles) on the crystal surface, (III)
surface diffusion of the solvated ions
(particles) toward active centers, (IV)
desolvation of the ions (particles), (V)
incorporation of the ions (particles) into
the crystal lattice, (VI) counter diffusion
of the liberated solvent (water) into the
bulk solution
4.PHYSIOLOGY AND PROPOSED
MECHANISMS:
Many theories have been proposed to
explain inert gas narcosis.
The first, put forward in 1835 by Junod
and later in 1881 by Moxon, suggested
increased pressure alone as the factor
involved. Junod considered that "the
increased density of the air lessened the
calibre of the venous vessels, resulting in
greater blood flow in the arterial system
and towards principal nerve centres
especially the brain, protected 'by its
bony case from direct pressure". He
thought that this increased blood 'flow
stimulated the nerve centres and resulted
in narcosis.
Moxon, on the other hand, regarded the
increased pressure as driving the blood
from the surface of the body into parts
not accessible to respiratory exchange
and that this devitalised blood caused
emotional changes. These theories are
patently incorrect. If pressure did affect
superficial blood flow, cutaneous
blanching would be obvious but this does
not occur. The physical properties of the
body are such that it may be regarded as
incompressible, with pressure being
equalised throughout the body bulk. A
further argument against pressure alone
being responsible for inert gas narcosis is
the later demonstration that breathing
gas mixtures of different constituents at
the same pressures induced different
levels of mental and physical change.
The psychological aspect of deep diving
was once blamed as the cause of narcosis
(Hill and Greenwood, 1906). When
psychological tests were carried out on
divers who had failed to complete tasks
under pressure. Phillips had little
hesitation in ascribing the objective
mental changes of his deep divers to
mental instability. However, it was later
shown to be unlikely that claustrophobia
or other psychological deviation
contribute directly to inert gas narcosis
although they may provide a background
of instability against which early changes
of narcosis become more apparent.
Narcosis experienced under compressed
air was attributed to nitrogen by Behnke,
Thompson and Motley (1935). The
manner in which nitrogen acted was
considered to be due to its oil/water
solubility ratio, acting in the same manner
as the diphasic anaesthetic agents. The
correlation between solubility of
anaesthetic agents in water and lipid and
its depressant action had been described
much earlier by Meyer (1899). Behnke
and his co-workers found that if nitrogen
is replaced in a gas mixture by helium, the
narcotic effect is lessened or abolished.
Conversely if argon is substituted, the
narcosis is more profound and with
earlier onset. Such gases as krypton and
xenon have also been used in mixtures at
atmospheric pressure and have produced
definite central nervous system
depression and anaesthesia in both
animals and man. ('Lawrence, Loomis,
Tobias and Turpin, 1946; Cullen and
Gross, 1951; Carpenter, 1953).
The ease with which a gas promotes
narcosis under pressure is directly
proportional to its fat solubility and
oil/water distribution coefficient
Bennett (1964) using auditory provoked
stimuli recorded from the cortex of cats,
has suggested that the most likely sites
for blockage are the central synapses, and
that the level of narcosis is related to a
critical concentration of inert gas
molecules at these sites.
A further theoretical site of action of
nitrogen is within the neuron itself or
within the neuron/glial unit which has
been demonstrated so well by Hyden
(1962). He describes how the glial
supporting cell entirely covers the neuron
and acts as the barrier between the
neuron and the capillary, and the two
constitute a biochemical and functional
unit.
Hyden pointed out that the glial cell was
composed of 70 per cent lipoid material
while the neuron was only 5 per cent.
Thus the glial cell might be expected to
absorb more nitrogen than the neuron
and be more affected by any deranging
influence. Should this occur, oxygen
consumption of the glia will drop as will
its efficiency. This depletion of energy
may cause delay in ionic potassium and
sodium exchange with the neuron, to
delay in substrate transfer and ultimately
to cessation of adequate function of
neuron and glia.
A similar theory of decreased membrane
permeability was proposed by Mullins
(1954) although he argued that it was
inert gas molecules accumulating in the
membrane pores that hindered
permeability of ionic material
The argument that the brain consists
largely of water and is, therefore, unlikely
to be influenced by highly fat-soluble
compounds is put forward by antagonists
of the 'lipid theory of narcosis and
anaesthesia, mainly Pauling (1961). He
offers, as alternative, a theory of
microcrystal formation within cell
cytoplasm quite independent of lipid cell
membranes or other structures. Pauling
suggests that nitrogen and other inert
gases such as xenon, take part in the
formation of clathrates, in which the gas
atoms occupy chambers in a framework
of molecules. These molecules interact
with one another through hydrogen
bonding to give nitrogen or xenon
hydrate. The clathrates to be present at
body temperature must be stabilised by
cytoplasmic proteins, hence this theory is
sometimes referred to as "protein
binding". Pauling postulates that these
microcrystals act in two ways by trapping
electrically charged ions associated with
impulse conduction and damping down
electrical circuits, and 'by preventing
close enough contact of
enzyme/substrate configurations and
thus decreasing the rate of chemical lune,
reactions and, therefore, metabolic rate of
cells.
5. CONCLUSION: EMPHASISING THE
ROLE OF MASS TRANSFER IN
UNDERSTANDING NITROGEN
NARCOSIS
Although implicitly clear that a
knowledge of mass transfer mechanisms
is very necessary alongside physiology to
determine the following
1. Diffusivity constants that drive
nitrogen transfer.
2. Rates at which inspired gases
reach the heart,brain and lungs
considering diffusion in
combination with perfusion.
3. Interphase mass transfer
coefficients to examine diffusion of
nitrogen between lipids and water,
and the departure from
equilibrium driving the same.
4. Supersaturation and saturation
phenomenon are driven by partial
pressures and are important to
determine possible decompression
sickness and theoretical bubble
formation possibilities within
capillaries.
5. Bubble formation causes
decompression sickness which
aggravates narcosis and is often
not reversible in terms of the
damage it inflicts.
6. Crystallisation is a mass transfer
phenomenon and is among the
postulated theories to explain
narcosis.
Thus a thorough understanding of the
phenomenon of nitrogen narcosis using
improved techniques of mass transfer
with its mathematical rigour to
compliment physiology studies, can help
make diving safer and possibly allow us to
change the composition of anaesthetic
agents involved in surgeries. This makes
it a fascinating area to explore with
opportunities as vast as the waters itself.
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