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Muscular damage and intravascular haemolysis during an 18 hour subterranean exploration in a cave of 700 m depth
  1. E Stenner1,
  2. E Gianoli2,
  3. B Biasioli2,
  4. C Piccinini2,
  5. G Delbello3,
  6. A Bussani4
  1. 1Department of Sports Medicine, Faculty of Medicine and Surgery, University of Trieste, Italy
  2. 2Clinical Research Laboratories, Maggiore Hospital, Trieste, Italy
  3. 3Department of Sports Medicine, Faculty of Medicine and Surgery, Trieste, Italy
  4. 4Hydrores Sas, Trieste
  1. Correspondence to:
 Dr Elisabetta Stenner
 Department of Sports Medicine, Faculty of Medicine and Surgery, University of Trieste, Italy; elisabetta.stenner{at}


Objective: To verify presence and severity of muscular and/or intravascular damage during a subterranean exploration of long duration.

Methods: We measured serum levels of creatine kinase (CK) and lactate dehydrogenase (LDH) as markers of muscular damage. We also measured haptoglobin as a marker of intravascular haemolysis, and platelets and leucocytes as markers of inflammation.

Results: We found in all the participants an increase in CK, LDH, and platelets and leucocytes (mainly due to neutrophilia and monocytosis), and a decrease in the level of haptoglobin and circulating lymphocytes.

Conclusions: The observed data suggest that continuous effort during long alpine subterranean explorations, environmental conditions, sleep deprivation, multiple impacts on rocks, and compression caused by bindings of the caving harness cause muscle damage, intravascular haemolysis, inflammation response, and immunological changes.

  • CK, creatine kinase
  • CK-MB, creatine kinase isoenzyme MB
  • LDH, lactate dehydrogenase
  • Potholing
  • muscle damage
  • endurance
  • CK
  • haptoglobin

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  • * To ascend, climbers use a bolt belayed rope, and wear a caving sitting harness and chest straps. In order to climb back up a rope they use two belays, a ventral one and one attached to the hand by means of a stirrup on the foot. The technique consists of raising the hands with the belay, and then the legs in the stirrup, and then pushing down with the legs so that the ventral belay slides down until the legs are completely extended. In this way, “frog after frog”, the potholers reach the exit.

  • Competing interests: none