Five key advances that have been observed and changed our thinking are as follows. Immune responses probably complicate bubble formation and their effects. Bubbles in blood are not the same as bubbles in a beer bottle. Platelets are affected and interact with the bubble. Complement is activated.
Bubbles reflect stress but the immune response equals strain on the system.
Relatively small bubbles can have disproportionate effects when lodged in gas loaded tissues. There is a distict clinical picture caused by each type or they may all be present and give a mixed picture. Decompression illness should be viewed as probabilistic as opposed to deterministic. We got our decompression tables by pure brute force experimentation. We have augmented this data by the probabilistic calculation of risk.