Even a small amount of air (0.5 mL) can be fatal, especially if it reaches the cerebral or coronary vasculature. Some physiological effects of gas bubbles include protein denaturation, leukocyte activation, and endothelial damage which lead to microvascular leak and edema, hemorrhage, infarct, and cell death. Gas bubbles in the systemic vasculature usually lodge in small vessels, producing ischemia distal to the blockage and local activation of the inflammatory cascade. AGE happens when lung tissue tears and gas bubbles enter the systemic circulation. This can cause pneumothorax, pneumomediastinum, subcutaneous emphysema, or AGE. Divers who hold their breath as they ascend (or those with obstructive airway diseases such as asthma or chronic obstructive pulmonary disease ) can suffer an overexpansion injury and alveolar rupture. The lung volume is cut in half while the pressure doubles when a diver reaches a depth of 10 meters. Boyle’s law can explain pulmonary barotrauma and AGE. According to Boyle’s Law, if the temperature is constant, the volume of a gas varies inversely with pressure. In the example of an undersea diver, the ambient pressure increases by 1 atm for every 10 meters (33 feet) of depth. However, the areas of the body that are air-filled (lungs, sinuses, middle ear, gas in bowels, and cavities in teeth) are the structures affected by barotrauma. Usually, these structures are usually connected to the outside world to allow for free air exchange, but if they are blocked the high-pressure air will push on tissues surrounding the low-pressure area and this can cause tissue damage when the pressure gradient exceeds the tensile strength of the tissues involved. The human body is mostly comprised of water, which is minimally compressible, thus pressure changes do not typically directly affect these portions of the body.
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