{"id":4518,"date":"2025-01-08T12:49:34","date_gmt":"2025-01-08T04:49:34","guid":{"rendered":"http:\/\/scubatechphilippines.com\/scuba_blog\/?p=4518"},"modified":"2025-01-08T12:49:34","modified_gmt":"2025-01-08T04:49:34","slug":"decompression-sickness-immune-system","status":"publish","type":"post","link":"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/","title":{"rendered":"DCS and the Immune System"},"content":{"rendered":"\n<h1 class=\"wp-block-heading\">DCS and the Immune System<\/h1>\n\n\n\n<p>The link between DCS and the immune system still isn&#8217;t well understood in diving medicine; although numerous scientific studies have shown that a link probably exists.<\/p>\n\n\n\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-transparent ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title ez-toc-toggle\" style=\"cursor:pointer\">Article Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#Bubbles-during-DCS-and-the-immune-system\" >Bubbles during DCS and the immune system<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#The-immune-response\" >The immune response<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#The-immune-system-attacks-DCS-bubbles\" >The immune system attacks DCS bubbles<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#The-immune-system-clots-around-DCS-bubbles\" >The immune system clots around DCS bubbles<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#Micro-bubbles-also-cause-an-immune-response\" >Micro-bubbles also cause an immune response<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#Further-reading-on-DCS-and-the-immune-system\" >Further reading on DCS and the immune system<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#About-The-Author\" >About The Author<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/decompression-sickness-immune-system\/#Purchase-my-exclusive-diving-ebooks\" >Purchase my exclusive diving ebooks!<\/a><\/li><\/ul><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Bubbles-during-DCS-and-the-immune-system\"><\/span>Bubbles during DCS and the immune system<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Dive medicine research has shown that decompression-related bubbles formed within the body on ascent will trigger an immune system response. For this reason, immune-suppressant drugs are often administered during hyperbaric treatment for <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/types-decompression-sickness-dcs\/\">decompression sickness<\/a>.<\/p>\n\n\n\n<div class=\"scuba-b4-h2-2\" style=\"margin-top: 10px;margin-bottom: 10px;\" id=\"scuba-3927326653\"><div class=\"scuba-adlabel\">Sponsored Link<\/div><script async src=\"\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-9354033900485448\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display:block;\" data-ad-client=\"ca-pub-9354033900485448\" \ndata-ad-slot=\"2393012471\" \ndata-ad-format=\"auto\" data-full-width-responsive=\"false\"><\/ins>\n<script> \n(adsbygoogle = window.adsbygoogle || []).push({}); \n<\/script>\n<\/div><h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The-immune-response\"><\/span>The immune response<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>The immune system reacts to bubbles as it would to any foreign body; such as a virus or bacteria. That reaction is as follows:<\/p>\n\n\n\n<p>When bubbles occur in the body they will attract blood proteins, as those proteins make contact with bubbles they change in molecular shape and solubility (denaturation).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The-immune-system-attacks-DCS-bubbles\"><\/span>The immune system attacks DCS bubbles<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>The denatured protein is recognized by the body and the body diverts white blood cells to &#8216;attack&#8217; the bubble, whilst also releasing histamines to dilate blood vessels in the area (local inflammation) that aids the travel of the white blood cells to where they are needed.<\/p>\n\n\n\n<p>The release of histamine also causes the surrounding blood vessel lining to become sticky so that white blood cells surrounding the bubble will &#8216;stick&#8217; in place and trap the bubble. This process is known as margination.<\/p>\n\n\n\n<p>The process of margination also causes cells in the blood vessel wall (endothelium cells) to separate and allow <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/diving-dehydration-and-dcs\/\">fluids<\/a>, white blood cells and the bubble\/s to leave the bloodstream and enter the surrounding tissues. &nbsp;This not only thickens the blood, but a sufficient loss of fluid from the bloodstream into the tissues can cause shock.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The-immune-system-clots-around-DCS-bubbles\"><\/span>The immune system clots around DCS bubbles<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>The separation of endothelium cells causes an additional reaction in the body; as it triggers a release of platelets into the area. These platelets combine with collagen to form a clot in the tissue around the bubble. Platelets also release serotonin which counters the effect of histamine and constricts blood flow to the area.<\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter\"><img decoding=\"async\" width=\"202\" height=\"250\" src=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2019\/08\/bubbles-dcs-immune-system.jpg\" alt=\"bubbles-dcs-immune-system\" class=\"wp-image-16818\"\/><\/figure>\n\n\n\n<p>When the bubble is sufficiently large, this process is intense and noticeable in the body; where the swelling and inflammation cause pain or limit local body function; or changes in blood chemistry cause rash or illness. If significantly intense, they become symptoms of <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/understanding-m-values-eric-baker\/\">decompression<\/a> sickness.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Micro-bubbles-also-cause-an-immune-response\"><\/span>Micro-bubbles also cause an immune response<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p>However, if the bubbles are small in size, this <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/dcs-immune-complement-diving\/\">immune response<\/a> may be sufficiently insignificant; so as to remain symptomatically unnoticeable to the victim. But if the occurrence of <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/sub-clinical-decompression-sickness-stress-micro-bubbles\/\">micro-bubbles<\/a> is, nonetheless, high in frequency, then there may be widespread low-intensity immune reactions throughout the body. A sub-clinical reaction, but a reaction that does have an impact on the individual.<\/p>\n\n\n\n<p>That impact may present general fatigue, weariness, sleepiness, reduced vitality, decreased energy or just a sense of being under par physically or mentally. Those symptoms are commonly known as <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/sub-clinical-decompression-sickness-stress-micro-bubbles\/\">decompression stress or sub-clinical DCS<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Further-reading-on-DCS-and-the-immune-system\"><\/span>Further reading on DCS and the immune system<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p><a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/dcs-immune-complement-diving\/\">The Complement System and Diving<\/a>&#8216; by Dr. Ernest Campbell<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=1853466&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">In vitro activation of human complement by nitrogen bubbles<\/a>. Shastri KA, Logue GL, Lundgren CE. Undersea Biomed Res. 1991 May;18(3):157-65.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=8514700&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Variability over time of complement activation induced by air bubbles\u00a0in human and rabbit sera<\/a>. Bergh K, Hjelde A, Iversen OJ, Brubakk AO. J Appl Physiol. 1993 Apr;74(4):1811-5.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=3494726&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Relation between complement activation and susceptibility to decompression sickness<\/a>. Ward CA, McCullough D, Fraser WD. J Appl Physiol. 1987 Mar;62(3):1160-6.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=9171463&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Diving decompression fails to activate complement<\/a>. Shastri KA, Logue GL, Lundgren CE, Logue CJ, Suggs DF. Undersea Hyperb Med. 1997 Jun;24(2):51-7.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=2316060&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Complement activation involvement in decompression sickness of rabbits<\/a>. Ward CA, McCullough D, Yee D, Stanga D, Fraser WD. Undersea Biomed Res. 1990 Jan;17(1):51-66.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=8653063&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Complement system response to decompression<\/a>. Pekna M, Ersson A. Undersea Hyperb Med. 1996 Mar;23(1):31-4.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=7619033&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Complement levels and exposure in the hypobaric chamber<\/a>. Brook WH, Secombe J, Seychell D. Aviat Space Environ Med. 1995 May;66(5):415-7.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=7775308&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Complement activation in divers after repeated air\/heliox dives and its possible relevance to DCS<\/a>. Hjelde A, Bergh K, Brubakk AO, Iversen OJ. J Appl Physiol. 1995 Mar;78(3):1140-4.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=8044147&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Effect of decompression on the complement system<\/a>. Katuntsev VP, Kozlov LV, Shcherbakova MA, Ageev VP, Sizoi MN. Aviakosm Ekolog Med. 1993 May-Jun;27(3):22-8. Russian.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=8286982&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Complement activation during saturation diving<\/a>. <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=8286982&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Stevens DM, Gartner SL, Pearson RR, Flynn ET, Mink RB, Robinson DH, Dutka AJ.<\/a> Undersea Hyperb Med. 1993 Dec;20(4):279-88.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=1887517&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Venous gas emboli and complement activation after deep repetitive air diving<\/a>. Zhang J, Fife CE, Currie MS, Moon RE, Piantadosi CA, Vann RD. Undersea Biomed Res. 1991 Jul;18(4):293-302.<\/p>\n\n\n\n<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/entrez\/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=9096825&amp;dopt=Abstract\" target=\"_blank\" rel=\"noreferrer noopener\">Activation of complement and neutrophils increases vascular permeability during air embolism<\/a>. Huang KL, Lin YC. Aviat Space Environ Med. 1997 Apr;68(4):300-5. <\/p>\n\n\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-dots\"\/>\n\n\n\n<div class=\"wp-block-columns alignwide is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-content-justification-center is-layout-constrained wp-block-column-is-layout-constrained\" style=\"flex-basis:25%\">\n<p><\/p>\n\n\n\n<figure class=\"wp-block-image aligncenter size-medium is-resized is-style-default\"><a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/andy-davis-technical-diving\/\"><img decoding=\"async\" width=\"300\" height=\"296\" src=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2018\/03\/Cartoon-Andy-900x900-1-300x296.png\" alt=\"Andy Davis Technical Sidemount Wreck Diving Subic Bay Philippines RAID Courses Training\" class=\"wp-image-6812\" style=\"width:225px;height:222px\" srcset=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2018\/03\/Cartoon-Andy-900x900-1-300x296.png 300w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2018\/03\/Cartoon-Andy-900x900-1-1024x1009.png 1024w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2018\/03\/Cartoon-Andy-900x900-1-768x757.png 768w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2018\/03\/Cartoon-Andy-900x900-1.png 1280w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-constrained wp-block-column-is-layout-constrained\" style=\"flex-basis:75%\">\n<h2 class=\"wp-block-heading has-text-align-center\"><span class=\"ez-toc-section\" id=\"About-The-Author\"><\/span>About The Author<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-image aligncenter size-full\"><a href=\"https:\/\/buymeacoffee.com\/andydavistech\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" width=\"274\" height=\"77\" src=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2022\/12\/bmc-button-1-1.png\" alt=\"\" class=\"wp-image-27046\" srcset=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2022\/12\/bmc-button-1-1.png 274w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2022\/12\/bmc-button-1-1-250x70.png 250w\" sizes=\"(max-width: 274px) 100vw, 274px\" \/><\/a><\/figure>\n\n\n\n<p><a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/andy-davis-technical-diving\/\">Andy Davis<\/a> is a <a href=\"https:\/\/scubatechphilippines.com\/raid-diving-courses-philippines\/raid\/\">RAID<\/a>, PADI TecRec, ANDI, BSAC, and SSI-qualified independent <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/what-is-technical-diving\/\">technical diving<\/a> instructor who specializes in teaching <a href=\"https:\/\/scubatechphilippines.com\/sidemount-courses\/\">sidemount<\/a>, <a href=\"https:\/\/scubatechphilippines.com\/technical-diving-courses\/\">trimix<\/a>, and <a href=\"https:\/\/scubatechphilippines.com\/technical-diving-courses\/\">advanced wreck<\/a> diving courses.<\/p>\n<\/div>\n<\/div>\n\n\n\n<p>Currently residing in <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/subic-bay-wreck-diving-sites\/\">Subic Bay, Philippines<\/a>; he has amassed more than 10,000 open-circuit and CCR dives over three decades of challenging diving across the globe.<\/p>\n\n\n\n<p><a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/andy-davis-technical-diving\/\">Andy<\/a> has published numerous diving magazine articles and designed advanced certification courses for several dive training agencies, He regularly tests and reviews new <a href=\"https:\/\/scubatechphilippines.com\/scuba_blog\/scuba-equipment-shopping-buying-best-dive-gear\/\">dive gear<\/a> for scuba equipment manufacturers. Andy is currently writing a series of <a href=\"https:\/\/www.buymeacoffee.com\/andydavistech\/extras\">advanced diving books <\/a>and creating a range of <a href=\"https:\/\/www.redbubble.com\/people\/andydavistech\/shop\">tech diving clothing and accessories<\/a>.<\/p>\n\n\n\n<p>Prior to becoming a professional technical diving educator in 2006, Andy was a commissioned officer in the Royal Air Force and has served in Iraq, Afghanistan, Belize, and Cyprus.<\/p>\n\n\n\n<p>In 2023, Andy was named in the &#8220;<a rel=\"noreferrer noopener\" href=\"https:\/\/gue.com\/blog\/sidemount-andy-davies\/\" target=\"_blank\">Who&#8217;s Who of Sidemount<\/a>&#8221; list by GUE InDepth Magazine.<\/p>\n\n\n\n<h3 class=\"wp-block-heading has-text-align-center has-palette-color-7-color has-vivid-red-background-color has-text-color has-background has-link-color wp-elements-dd81a6de961563c5bf17302e4376cbd2\"><span class=\"ez-toc-section\" id=\"Purchase-my-exclusive-diving-ebooks\"><\/span>Purchase my exclusive diving ebooks!<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<div class=\"wp-block-columns is-not-stacked-on-mobile is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/buymeacoffee.com\/andydavistech\/e\/233191\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" width=\"652\" height=\"1024\" src=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/03\/Gas-Management-Book-Cover-Image-652x1024.jpg\" alt=\"Gas Management For Scuba Divers Book\" class=\"wp-image-26264\" srcset=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/03\/Gas-Management-Book-Cover-Image-652x1024.jpg 652w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/03\/Gas-Management-Book-Cover-Image-191x300.jpg 191w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/03\/Gas-Management-Book-Cover-Image-768x1206.jpg 768w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/03\/Gas-Management-Book-Cover-Image-96x150.jpg 96w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/03\/Gas-Management-Book-Cover-Image.jpg 794w\" sizes=\"(max-width: 652px) 100vw, 652px\" \/><\/a><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/buymeacoffee.com\/andydavistech\/e\/233171\" target=\"_blank\" rel=\"noreferrer noopener\"><img decoding=\"async\" width=\"652\" height=\"1024\" src=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/05\/Shearwater-Gradient-Factors-ebook-652x1024.jpg\" alt=\"Become A Shearwater Power User Book\" class=\"wp-image-26382\" srcset=\"https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/05\/Shearwater-Gradient-Factors-ebook-652x1024.jpg 652w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/05\/Shearwater-Gradient-Factors-ebook-191x300.jpg 191w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/05\/Shearwater-Gradient-Factors-ebook-768x1206.jpg 768w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/05\/Shearwater-Gradient-Factors-ebook-978x1536.jpg 978w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/05\/Shearwater-Gradient-Factors-ebook-95x150.jpg 95w, https:\/\/scubatechphilippines.com\/scuba_blog\/wp-content\/uploads\/2024\/05\/Shearwater-Gradient-Factors-ebook.jpg 1200w\" sizes=\"(max-width: 652px) 100vw, 652px\" \/><\/a><\/figure>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<figure class=\"wp-block-image size-large\"><a 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