{"id":11385571,"date":"2009-07-15T00:00:00","date_gmt":"2009-07-14T22:00:00","guid":{"rendered":"https:\/\/alertdiver.eu\/uncategorized-cs_cz\/cestovani-letadlem-po-potapeni\/"},"modified":"2009-07-15T00:00:00","modified_gmt":"2009-07-14T22:00:00","slug":"cestovani-letadlem-po-potapeni","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/cestovani-letadlem-po-potapeni\/","title":{"rendered":"Cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed"},"content":{"rendered":"

V roce 1989 se DAN z\u00fa\u010dastnila prvn\u00edho workshopu na t\u00e9ma cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed (anglicky: Flying after Diving = FAD). Tento workshop sponzorovala L\u00e9ka\u0159sk\u00e1 spole\u010dnost pro podmo\u0159skou a hyperbarickou medic\u00ednu a hlavn\u00edmi projedn\u00e1van\u00fdmi t\u00e9maty zde byly p\u0159\u00edpady zran\u011bn\u00ed utrp\u011bn\u00fdch p\u0159i pot\u00e1p\u011bn\u00ed, jako\u017e i pokusy zam\u011b\u0159en\u00e9 na cestov\u00e1n\u00ed letadlem po uskute\u010dn\u011bn\u00e9m pot\u00e1p\u011bn\u00ed. Zm\u00edn\u011bn\u00e9 pokusy se prov\u00e1d\u011bly ve Zdravotn\u00edm st\u0159edisku university Duke (1-3).
P\u0159i tomto setk\u00e1n\u00ed\/workshopu v roce 1989 \u00fa\u010dastn\u00edci odsouhlasili z\u00e1sady pro cestov\u00e1n\u00ed letadlem po uskute\u010dn\u011bn\u00e9m pot\u00e1p\u011bn\u00ed. Podle nich se doporu\u010duje: Po\u010dkat s odletem po dobu nejm\u00e9n\u011b 12 hodin po pot\u00e1p\u011bn\u00ed bez dekompresn\u00edch zast\u00e1vek, kter\u00e9 trvalo nejm\u00e9n\u011b 2 hodiny b\u011bhem jednoho dne; d\u00e1le necestovat letadlem alespo\u0148 24 hodin po v\u00edcedenn\u00edm neomezen\u00e9m pot\u00e1p\u011bn\u00ed bez dekompresn\u00edch zast\u00e1vek. <\/p>\n

DAN doporu\u010dovala konzervativn\u011bj\u0161\u00ed p\u0159\u00edstup, a sice po\u010dkat 24 hodin po ka\u017ed\u00e9m pot\u00e1p\u011bn\u00ed. Z\u00e1stupci rekrea\u010dn\u00edho pot\u00e1p\u011bn\u00ed proti tomu nam\u00edtali a tvrdili, \u017ee riziko dekompresn\u00ed nemoci (DCS) kv\u016fli letu uskute\u010dn\u011bn\u00e9m po pot\u00e1p\u011bn\u00ed je p\u0159\u00edli\u0161 n\u00edzk\u00e9 na to, aby se vy\u017eadovalo 24-hodinov\u00e9 vy\u010dk\u00e1v\u00e1n\u00ed; nav\u00edc by to zp\u016fsobovalo finan\u010dn\u00ed ztr\u00e1ty ostrovn\u00edm pot\u00e1p\u011b\u010dsk\u00fdm st\u0159edisk\u016fm.
V roce 1991 DAN sv\u00e1 pravidla zrevidovala a nyn\u00ed zn\u011bj\u00ed takto: Doporu\u010duje se nejm\u00e9n\u011b 12 hodin na povrchu po jedin\u00e9m ponoru bez dekompresn\u00ed zast\u00e1vky a v\u00edce ne\u017e 12 hodin po opakovan\u00fdch ponorech, po ponorech s dekompres\u00ed a po n\u011bkolika dnech pot\u00e1p\u011bn\u00ed (4, 5).
 <\/p>\n

Od t\u00e9 doby nechala DAN prov\u00e9st sv\u016fj vlastn\u00ed laboratorn\u00ed v\u00fdzkum na t\u00e9ma cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed. Krom\u011b toho jsme iniciovali dal\u0161\u00ed v\u00fdzkum zalo\u017een\u00fd na vyu\u017eit\u00ed \u00fadaj\u016f a informac\u00ed z\u00edskan\u00fdch p\u0159\u00edmo od zran\u011bn\u00fdch pot\u00e1p\u011b\u010d\u016f, jako\u017e i na v\u00fdsledc\u00edch vy\u0161et\u0159en\u00ed osob, kter\u00e9 cestovaly letadlem ji\u017e s p\u0159\u00edznaky nebo po rekompresn\u00ed terapii.
Experiment\u00e1ln\u00ed v\u00fdzkum cestov\u00e1n\u00ed letadlem po uskute\u010dn\u011bn\u00e9m pot\u00e1p\u011bn\u00ed P\u0159i op\u011btovn\u00e9m prov\u011b\u0159en\u00ed \u00fadaj\u016f a informac\u00ed dostupn\u00fdch a diskutovan\u00fdch b\u011bhem workshopu v roce 1989 se uk\u00e1zalo, \u017ee neexistuje dostatek empirick\u00fdch d\u016fkaz\u016f, kter\u00e9 by opodstat\u0148ovaly jak\u00e9koliv navrhovan\u00e9 a doporu\u010dovan\u00e9 z\u00e1sady. Aby se takov\u00e9 d\u016fkazy z\u00edskaly, zah\u00e1jila DAN v roce 1992 v Hyperbarick\u00e9m st\u0159edisku univerzity Duke experiment\u00e1ln\u00ed pokusy na cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed, p\u0159i\u010dem\u017e se simulovaly lety ve v\u00fd\u0161ce 8 000 stop (2 438 metr\u016f). Tyto pokusy skon\u010dily v roce 1999 s v\u00fdsledkem 40 v\u00fdskyt\u016f DCS p\u0159i 802 vystaven\u00edch se \u00fa\u010dink\u016fm modelov\u00e9 situace. <\/p>\n

Na z\u00e1klad\u011b zm\u00edn\u011bn\u00fdch v\u00fdsledk\u016f stanovilo pravidla pro cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed i americk\u00e9 n\u00e1mo\u0159nictvo a tak\u00e9 se podle nich vypracovaly konsensu\u00e1ln\u00ed z\u00e1sady pro cestov\u00e1n\u00ed letadlem po rekrea\u010dn\u00edm pot\u00e1p\u011bn\u00ed (tato pravidla vytvo\u0159ili a odsouhlasili v roce 2002 \u00fa\u010dastn\u00edci workshopu, kter\u00fd sponzorovala DAN). Sborn\u00edk v\u00fdsledk\u016f experiment\u00e1ln\u00edho v\u00fdzkumu i n\u00e1sledn\u00e9ho workshopu vy\u0161el v roce 2004 (6, 7). Zp\u0159esn\u011bn\u00e9 z\u00e1sady pro cestov\u00e1n\u00ed letadlem po rekrea\u010dn\u00edm pot\u00e1p\u011bn\u00ed nyn\u00ed zn\u011bj\u00ed takto: <\/p>\n

(a) Pro jeden bezdekompresn\u00ed ponor se doporu\u010duje minim\u00e1ln\u011b 12 hodin na povrchu p\u0159ed nastoupen\u00edm cesty letadlem.
(b) Po opakovan\u00fdch ponorech b\u011bhem jednoho dne nebo po pot\u00e1p\u011bn\u00ed n\u011bkolik dn\u016f po sob\u011b se doporu\u010duje minim\u00e1ln\u011b 18 hodin na povrchu p\u0159ed nastoupen\u00edm cesty letadlem.
(c) Co se t\u00fd\u010de ponor\u016f vy\u017eaduj\u00edc\u00edch dekompresn\u00ed zast\u00e1vky, existuje jen m\u00e1lo d\u016fkaz\u016f, na z\u00e1klad\u011b kter\u00fdch by bylo mo\u017eno stanovit n\u011bjak\u00fd p\u0159esn\u00fd limit, p\u0159esto se jev\u00ed jako opodstatn\u011bn\u00e9 doporu\u010den\u00ed str\u00e1vit v tomto p\u0159\u00edpad\u011b na povrchu p\u0159ed nastoupen\u00edm cesty letadlem podstatn\u011b d\u00e9le ne\u017e 18 hodin.
 <\/p>\n

Zad\u00e1n\u00ed DAN pro zm\u00edn\u011bn\u00e9 pokusy zn\u011blo: Zjistit a ur\u010dit p\u0159edletov\u00e9 \u010dasov\u00e9 lh\u016fty pobytu na povrchu pot\u0159ebn\u00e9 po proveden\u00ed nejdel\u0161\u00edch rekrea\u010dn\u00edch ponor\u016f bez dekompresn\u00ed zast\u00e1vky – jak po jedin\u00e9m ponoru, tak po ponorech opakovan\u00fdch. D\u00edky sponzorov\u00e1n\u00ed n\u00e1mo\u0159nictva Spojen\u00fdch st\u00e1t\u016f za\u010dal v roce 2002 dal\u0161\u00ed v\u00fdzkum, kter\u00fd prob\u00edh\u00e1 dodnes. Jeho hlavn\u00edm c\u00edlem je zkoumat kr\u00e1tkodob\u00e9 ponory bez zast\u00e1vek i ponory dekompresn\u00ed, kter\u00e9 se p\u0159edt\u00edm netestovaly. Do dne\u0161n\u00edho dne byly zaznamen\u00fdny \u010dty\u0159i p\u0159\u00edpady DCS a sedm “mali\u010dkost\u00ed” (t.j. margin\u00e1ln\u00ed DCS nebo velmi m\u00edrn\u00e9 p\u0159\u00edznaky po dobu krat\u0161\u00ed ne\u017e jedna hodina), to v\u0161e p\u0159i 368 vystaven\u00edch se \u00fa\u010dink\u016fm modelov\u00e9 situace. P\u0159\u00edpadov\u00e1 srovn\u00e1vac\u00ed studie na t\u00e9ma cestov\u00e1n\u00ed letadlem po uskute\u010dn\u011bn\u00e9m pot\u00e1p\u011bn\u00ed Souvislost mezi nebezpe\u010d\u00edm DCS a d\u00e9lkou pobytu na povrchu p\u0159ed nastoupen\u00edm cesty letadlem se tak\u00e9 zji\u0161\u0165ovala pomoci p\u0159\u00edpadov\u00e9 srovn\u00e1vac\u00ed studie vyhodnocen\u00edm \u00fadaj\u016f ulo\u017een\u00fdch v datab\u00e1zi DAN o 382 p\u0159\u00edpadech pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed utrp\u011bli zran\u011bn\u00ed v porovn\u00e1n\u00ed s tzv. kontroln\u00edmi vzorky (t.j. pot\u00e1p\u011b\u010di) bez zran\u011bn\u00ed, kter\u00fdch bylo 245. <\/p>\n

Tato p\u0159\u00edpadov\u00e1 studie se uskute\u010dnila v r\u00e1mci akce nazvan\u00e9 Pot\u00e1p\u011b\u010dsk\u00fd v\u00fdzkumn\u00fd projekt (8). P\u0159\u00edpadov\u00e9 kontroln\u00ed studie nemohou zjistit a zm\u011b\u0159it absolutn\u00ed riziko, nebo\u0165 riziko u celkov\u00e9 populace je nezn\u00e1m\u00e9; zji\u0161\u0165uje se pouze skute\u010dnost, zdali se faktor potenci\u00e1ln\u00edho nebezpe\u010d\u00ed vyskytuje \u010dast\u011bji u skute\u010dn\u00fdch p\u0159\u00edpad\u016f ne\u017e u kontroln\u00edch vzork\u016f (pot\u00e1p\u011b\u010d\u016f). Statisticky se hodnotili pot\u00e1p\u011b\u010di i \u00fadaje o profilech jejich jednotliv\u00fdch ponor\u016f. A stejn\u011b tak, jak se prok\u00e1zalo experiment\u00e1ln\u011b, nazna\u010dily i v\u00fdsledky t\u00e9to p\u0159\u00edpadov\u00e9 studie, \u017ee riziko DCS se zvy\u0161uje \u00fam\u011brn\u011b se zkracov\u00e1n\u00edm doby str\u00e1ven\u00e9 na povrchu p\u0159ed nastoupen\u00edm cesty letadlem. D\u00e1le se potvrdilo, \u017ee riziko DCS je vy\u0161\u0161\u00ed, jestli\u017ee se nejhlub\u0161\u00ed ponor uskute\u010dn\u00ed posledn\u00ed den pot\u00e1p\u011bn\u00ed. P\u0159\u00edpadov\u00e9 srovn\u00e1vac\u00ed studie zji\u0161\u0165uj\u00ed rozd\u00edlnost relativn\u00edho rizika za jedn\u011bch podm\u00ednek oproti relativn\u00edmu riziku za jin\u00fdch podm\u00ednek. <\/p>\n

Anal\u00fdzou se nap\u0159. zjistilo, \u017ee jestli\u017ee se definuje relativn\u00ed riziko DCS po ponoru do hloubky 60 stop mo\u0159sk\u00e9 vody (18 metr\u016f mo\u0159sk\u00e9 vody) a 24-hodinov\u00e9m pobytu na povrchu koeficientem 1, pak je relativn\u00ed riziko po ponoru do hloubky 60 stop a 12-ti hodinov\u00e9m pobytu na povrchu 2,5x vy\u0161\u0161\u00ed a relativn\u00ed riziko pro ponoru do hloubky 130 stop (40 metr\u016f) a 12-ti hodinov\u00e9m pobytu na povrchu dokonce 7x vy\u0161\u0161\u00ed.
Z 382 p\u0159\u00edpad\u016f DCS FAD uveden\u00fdch v t\u00e9to p\u0159\u00edpadov\u00e9 srovn\u00e1vac\u00ed studii \u010dekalo 34 procent pot\u00e1p\u011b\u010d\u016f na povrchu d\u00e9le ne\u017e 24 hodin (od posledn\u00edho ponoru) a teprve potom nastoupili cestu letadlem. To se li\u0161\u00ed od odsouhlasen\u00fdch z\u00e1sad FAD, kter\u00e9 na z\u00e1klad\u011b pokus\u016f prov\u00e1d\u011bn\u00fdch v komo\u0159e stanovuj\u00ed, \u017ee i v p\u0159\u00edpad\u011b opakovan\u00e9ho pot\u00e1p\u011bn\u00ed sta\u010d\u00ed pobyt na povrchu v d\u00e9lce 18 hodin.
 <\/p>\n

Experiment\u00e1ln\u00ed pokusy se prov\u00e1d\u011bly se such\u00fdmi a odpo\u010dat\u00fdmi jedinci, proto se nab\u00edz\u00ed ot\u00e1zka, zdali nejsou rekrea\u010dn\u00ed pot\u00e1p\u011b\u010di vystaveni v\u011bt\u0161\u00edmu riziku DCS, ne\u017e jedinci, kte\u0159\u00ed se \u00fa\u010dastnili experiment\u00e1ln\u00edch pokus\u016f v komo\u0159e. A jestli\u017ee tomu tak je, o kolik v\u011bt\u0161\u00edmu riziku? P\u0159\u00edpadov\u00e1 srovn\u00e1vac\u00ed studie na to poskytuje ur\u010ditou odpov\u011b\u010f. V n\u00ed se uv\u00e1d\u00ed, \u017ee jestli\u017ee se definuje relativn\u00ed riziko DCS po ponoru do hloubky 60 stop mo\u0159sk\u00e9 vody a 36-hodinov\u00e9m pobytu na povrchu koeficientem 1, pak je relativn\u00ed riziko po 24 hodin\u00e1ch pobytu na povrchu 1,7x vy\u0161\u0161\u00ed a po 12-ti hodinov\u00e9m pobytu na povrchu dokonce 4,2x vy\u0161\u0161\u00ed. P\u0159\u00edpadov\u00e1 srovn\u00e1vac\u00ed studie proveden\u00e1 s rekrea\u010dn\u00edmi pot\u00e1p\u011b\u010di nazna\u010duje, \u017ee pobytem na povrchu del\u0161\u00edm ne\u017e 24 hodin se ochrana proti riziku DCS je\u0161t\u011b zvy\u0161uje, ov\u0161em ji\u017e nijak v\u00fdznamn\u011b.<\/p>\n

Cesta letdlem s p\u0159\u00edznaky DCS<\/strong>
Jeden v\u00fdzkum \u00fadaj\u016f DAN z let 1987-1990 uk\u00e1zal, \u017ee 5,6% z 1 159 p\u0159\u00edpad\u016f DCS nastalo b\u011bhem letu nebo po n\u011bm a 13,8% m\u011blo p\u0159\u00edznaky p\u0159ed letem (9). Zpr\u00e1vy DAN o pot\u00e1p\u011bn\u00ed v letech 2000-2004 uv\u00e1d\u011bj\u00ed, \u017ee 7,1% z 2 438 p\u0159\u00edpad\u016f DCS nastalo b\u011bhem cesty letadlem nebo po n\u00ed a 10% m\u011blo p\u0159\u00edznaky p\u0159ed letem (10-14).
Proto\u017ee cesta letadlem znamen\u00e1 dal\u0161\u00ed dekompresn\u00ed stres, sledovalo se, jak\u00e9 dopady m\u00e1 cestov\u00e1n\u00ed letadlem na pot\u00e1p\u011b\u010de s p\u0159\u00edznaky DCS, a sice co se t\u00fd\u010de z\u00e1va\u017enosti stavu, ale tak\u00e9 celkov\u00e9ho v\u00fdsledku l\u00e9\u010dby (9). Z\u00e1va\u017enost stavu se zji\u0161\u0165ovala formou stanoven\u00ed kone\u010dn\u00e9 diagn\u00f3zy DCS bu\u010f typu II nebo typu I a v\u00fdsledek l\u00e9\u010dby se m\u011b\u0159il stupn\u011bm dosa\u017een\u00e9 \u00falevy po prvn\u00ed rekompresi a p\u0159etrv\u00e1vaj\u00edc\u00edmi p\u0159\u00edznaky po t\u0159ech m\u011bs\u00edc\u00edch od ukon\u010den\u00ed v\u0161ech rekompres\u00ed.<\/p>\n

Nam\u011b\u0159en\u00e9 v\u00fdsledky z\u00e1va\u017enosti DCS se porovn\u00e1valy u pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed absolvovali rekomprese a letadlem necestovali, oproti v\u00fdsledk\u016fm z\u00edskan\u00fdch od pot\u00e1p\u011b\u010d\u016f, u kter\u00fdch se dostavily p\u0159\u00edznaky b\u011bhem letu nebo po n\u011bm a teprve n\u00e1sledn\u011b absolvovali rekompresi (rekomprese). V\u0161echny t\u0159i stupn\u011b z\u00e1va\u017enosti stavu byly negativn\u011b ovlivn\u011bny cestov\u00e1n\u00edm letadlem s existuj\u00edc\u00edmi p\u0159\u00edznaky: DCS typu II byla 1,6x pravd\u011bpodobn\u011bj\u0161\u00ed, ne\u00fapln\u00e1 \u00faleva byla 1,8x pravd\u011bpodobn\u011bj\u0161\u00ed a p\u0159etrv\u00e1vaj\u00edc\u00ed p\u0159\u00edznaky byly 2,7x pravd\u011bpodobn\u011bj\u0161\u00ed.
Podobn\u00e1 anal\u00fdza se provedla u pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed \u010dekali p\u0159ed cestou letadlem m\u00e9n\u011b ne\u017e 24 hodin. Hodnotil se v\u00fdsledek l\u00e9\u010dby ve smyslu p\u0159etrv\u00e1vaj\u00edc\u00edch p\u0159\u00edznak\u016f po proveden\u00ed v\u0161ech rekompres\u00ed (15). <\/p>\n

Referen\u010dn\u00ed skupinou byli pot\u00e1p\u011b\u010di, kte\u0159\u00ed letadlem necestovali. Porovn\u00e1valy se dv\u011b skupiny: (a) Pot\u00e1p\u011b\u010di s p\u0159\u00edznaky p\u0159ed letem a (b) pot\u00e1p\u011b\u010di s p\u0159\u00edznaky po letu.
Z pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed letadlem necestovali, m\u011blo 38% p\u0159etrv\u00e1vaj\u00edc\u00ed p\u0159\u00edznaky po v\u0161ech dekompres\u00edch – oproti 49 procent\u016fm pot\u00e1p\u011b\u010d\u016f s p\u0159etrv\u00e1vaj\u00edc\u00edmi p\u0159\u00edznaky, kte\u0159\u00ed ji\u017e s p\u0159\u00edznaky cestovali letadlem, co\u017e znamen\u00e1 pom\u011br pod\u00edl\u016f pravd\u011bpodobnost\u00ed neboli m\u00edru relativn\u00edho rizika 1,5 (anglicky odds ratio, t.j. OR = 1,5) a 46 procent\u016fm pot\u00e1p\u011b\u010d\u016f s p\u0159etrv\u00e1vaj\u00edc\u00edmi p\u0159\u00edznaky, u kter\u00fdch se p\u0159\u00edznaky dostavily a\u017e po letu (OR=1,3). U 31% pot\u00e1p\u011b\u010d\u016f s typick\u00fdmi p\u0159\u00edznaky (\u00fanava, nutkavost na zvracen\u00ed, z\u00e1vrat\u011b) p\u0159\u00edznaky p\u0159etrv\u00e1valy. U pot\u00e1p\u011b\u010d\u016f s bolestmi p\u0159etrv\u00e1valy p\u0159\u00edznaky ve 40% p\u0159\u00edpad\u016f a jejich pom\u011br pod\u00edl\u016f pravd\u011bpodobnost\u00ed (OR) byl 1,5 oproti referen\u010dn\u00ed skupin\u011b. <\/p>\n

Pot\u00e1p\u011b\u010di s m\u00edrn\u00fdmi neurologick\u00fdmi p\u0159\u00edznaky m\u011bly p\u0159etrv\u00e1vaj\u00edc\u00ed p\u0159\u00edznaky ve 40% (OR = 1,4) a pot\u00e1p\u011b\u010di s v\u00e1\u017en\u00fdmi neurologick\u00fdmi p\u0159\u00edznaky m\u011bly p\u0159\u00edznaky p\u0159etrv\u00e1vaj\u00edc\u00ed v 45% (OR = 1,8).
Cestov\u00e1n\u00ed letadlem s ji\u017e existuj\u00edc\u00edmi p\u0159\u00edznaky je hodn\u011b ovlivn\u011bno pou\u010denost\u00ed a informovanost\u00ed p\u0159\u00edslu\u0161n\u00e9ho pot\u00e1p\u011b\u010de (zde plat\u00ed jednoduch\u00e9 a z\u00e1sadn\u00ed: “Ned\u011blejte to!”), ale n\u011bkdy se tak d\u011bje kv\u016fli leteck\u00e9 p\u0159eprav\u011b zran\u011bn\u00e9ho pot\u00e1p\u011b\u010de ze vzd\u00e1len\u00e9ho m\u00edsta, kde se pot\u00e1p\u011bl, do rekompresn\u00edho za\u0159\u00edzen\u00ed (16). Ot\u00e1zkou z\u016fst\u00e1v\u00e1, zdali mus\u00ed b\u00fdt v\u0161ichni pot\u00e1p\u011b\u010di s podez\u0159en\u00edm na dekompresn\u00ed zran\u011bn\u00ed p\u0159epravov\u00e1ni leteckou ambulanc\u00ed za okoln\u00edho tlaku podobn\u00e9ho jako na hladin\u011b mo\u0159e, nebo zdali mohou b\u00fdt pot\u00e1p\u011b\u010di s m\u00edrn\u00fdmi p\u0159\u00edznaky p\u0159epraveni norm\u00e1ln\u00edm komer\u010dn\u00edm letadlem (v b\u011b\u017en\u00e9 pou\u017e\u00edvan\u00e9 v\u00fd\u0161ce, t.j. s tlakem ni\u017e\u0161\u00edm ne\u017e na hladin\u011b mo\u0159e). Zde m\u016f\u017ee b\u00fdt d\u016fle\u017eit\u00fdm faktorem p\u0159i rozhodov\u00e1n\u00ed p\u0159edpokl\u00e1dan\u00e1 d\u00e9lka\/doba letu. <\/p>\n

126 pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed let\u011bli s p\u0159\u00edznaky bylo rozd\u011bleno do dvou skupin: Jedni \u010dekali p\u0159ed cestou letadlem m\u00e9n\u011b ne\u017e 24 hodin, druz\u00ed \u010dekali d\u00e9le ne\u017e 24 hodin. Srovn\u00e1vac\u00ed skupinu tvo\u0159ilo 1 509 p\u0159\u00edpad\u016f, kte\u0159\u00ed letadlem necestovali. Pot\u00e1p\u011b\u010di byli rozt\u0159\u00edd\u011bni podle z\u00e1va\u017enosti p\u0159\u00edpadu.
Kdy\u017e se zkoumal \u00fa\u010dinek p\u0159edletov\u00e9ho pobytu na povrchu p\u0159ed letem, zjistilo se, \u017ee rekomprese byla stejn\u011b \u00fasp\u011b\u0161n\u00e1 u pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed \u010dekali d\u00e9le ne\u017e 24 hodin (u 73% do\u0161lo k celkov\u00e9 \u00falev\u011b), jako u pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed letadlem necestovali v\u016fbec (71%). U pot\u00e1p\u011b\u010d\u016f, kte\u0159\u00ed \u010dekali na povrchu p\u0159ed letem m\u00e9n\u011b ne\u017e 24 hodin v\u0161ak byla zaznamen\u00e1na celkov\u00e1 \u00faleva jen u 34% p\u0159\u00edpad\u016f s v\u00e1\u017en\u00fdmi neurologick\u00fdmi p\u0159\u00edznaky a u 53% p\u0159\u00edpad\u016f s m\u00edrn\u00fdmi neurologick\u00fdmi p\u0159\u00edznaky. Doba letu bolesti neovlivnila. <\/p>\n

Cestov\u00e1n\u00ed letadlem po rekompresn\u00ed terapii K cest\u011b letadlem po terapii (anglicky: Flying after Treatment = FAT) zpravidla doch\u00e1z\u00ed tehdy, kdy\u017e je pot\u00e1p\u011b\u010d, kter\u00fd ji\u017e absolvoval terapii na DCI (co\u017e je dekompresn\u00ed onemocn\u011bn\u00ed zahrnuj\u00edc\u00ed DCS i tepennou  plynovou embolii) vystaven sekund\u00e1rn\u00ed dekompresi zp\u016fsoben\u00e9 v\u00fd\u0161kou letov\u00e9 dr\u00e1hy (17). V t\u00e9to souvislosti se nab\u00edz\u00ed d\u016fle\u017eit\u00e1 ot\u00e1zka: Jak dlouho mus\u00ed pot\u00e1p\u011b\u010d \u010dekat po terapii, ne\u017e m\u016f\u017ee let\u011bt v b\u011b\u017en\u00e9m komer\u010dn\u00edm letadle, kde nen\u00ed “norm\u00e1ln\u00ed” tlak?
 <\/p>\n

Nej\u010dast\u011bji doporu\u010dovan\u00e1 prodleva s odletem je t\u0159i dny od ukon\u010den\u00ed terapie. Negativn\u00ed \u00fa\u010dinek letu ve smyslu n\u00e1stupu recidivy po ukon\u010den\u00e9 terapii se zd\u00e1 b\u00fdt eliminov\u00e1n po t\u0159ech a\u017e \u010dty\u0159ech dnech, ale toto pozorov\u00e1n\u00ed vych\u00e1z\u00ed z m\u00e1lo ov\u011b\u0159en\u00fdch \u00fadaj\u016f. U pot\u00e1p\u011b\u010d\u016f s p\u0159etrv\u00e1vaj\u00edc\u00edmi p\u0159\u00edznaky i po rekompresi se v\u0161ak zdaj\u00ed b\u00fdt t\u0159i dny prodlevy m\u00e1lo na to, aby b\u011bhem letu nedo\u0161lo ke zhor\u0161en\u00ed. Hlub\u0161\u00ed pochopen\u00ed probl\u00e9mu FAT bude vy\u017eadovat dal\u0161\u00ed \u00fadaje o: (a) rozsahu recidivy bez cestov\u00e1n\u00ed letadlem a dopadech cestov\u00e1n\u00ed letadlem na z\u00e1va\u017enost stavu a (b) p\u0159etrv\u00e1v\u00e1n\u00ed p\u0159\u00edznak\u016f p\u0159i recidiv\u011b po letu v porovn\u00e1n\u00ed s p\u0159etrv\u00e1v\u00e1n\u00edm p\u0159\u00edznak\u016f p\u0159i recidiv\u011b v p\u0159\u00edpad\u011b necestov\u00e1n\u00ed letadlem.<\/p>\n","protected":false},"excerpt":{"rendered":"

V roce 1989 se DAN z\u00fa\u010dastnila prvn\u00edho workshopu na t\u00e9ma cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed (anglicky: Flying after Diving = FAD). Tento workshop sponzorovala L\u00e9ka\u0159sk\u00e1 spole\u010dnost…<\/p>\n","protected":false},"author":1,"featured_media":11374263,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[384],"tags":[],"authors":[856],"class_list":["post-11385571","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clanky","authors-dan-europe-staff-cs_cz"],"acf":[],"yoast_head":"\nCestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed - Alert Diver<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/alertdiver.eu\/cs_CZ\/clanky\/cestovani-letadlem-po-potapeni\/\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed - Alert Diver\" \/>\n<meta property=\"og:description\" content=\"V roce 1989 se DAN z\u00fa\u010dastnila prvn\u00edho workshopu na t\u00e9ma cestov\u00e1n\u00ed letadlem po pot\u00e1p\u011bn\u00ed (anglicky: Flying after Diving = FAD). 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