Aqua jogging-induced pulmonary oedema

Wenger, Mathias; Russi, EW

doi:10.1183/09031936.00116407

Cited by 14 publications

(9 citation statements)

References 8 publications

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“…Finally, symptoms related to pulmonary oedema occur earlier during sustained exercising in water than on land. In the case reported by WENGER and RUSSI [1] symptoms occured after 20 min, which matches other reports (see references quoted by WENGER and RUSSI [1], and also recently gathered data [9]). All in all, the occurrence of pulmonary oedema during various conditions of immersed exercising is not rare, which encourages efforts for a better understanding of the underlying pathophysiological mechanisms.…”

supporting

confidence: 78%

“…In addition, the work of breathing increases progressively during endurance exercise at constant work [5]. Therefore, it seems difficult to believe that stress failure of alveolar or bronchial capillaries is improbable in the case reported by WENGER and RUSSI [1]. In an experiment designed to compare immersed versus ground 30-min cycling, thoracic electrical impedance was lower during recovery on land after exercising in water than on ground, which reflected a larger amount of thoracic fluid, while stroke volume was simultaneously lower, i.e.…”

Section: To the Editorsmentioning

confidence: 69%

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mentioning

confidence: 99%

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Aqua jogging-induced pulmonary oedema

Regnard¹

2008

Eur Respir J

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To the Editors:The case study by WENGER and RUSSI [1], of pulmonary oedema occuring during aqua jogging, is interesting. Aqua jogging certainly lowers the burden to joints and tendons as compared with land running. Conversely, running or cycling at sustained intensity may lead to higher burden to lung tissue in water than on ground. In water, the exercising mechanical strain [2] is strengthened by congestion of pulmonary vessels (hence, decreased lung compliance) and also by the inspiratory loading due to hydrostatic pressure, which is likely to enlarge intraairway pressure swings [3,4]. In addition, the work of breathing increases progressively during endurance exercise at constant work [5]. Therefore, it seems difficult to believe that stress failure of alveolar or bronchial capillaries is improbable in the case reported by WENGER and RUSSI [1]. In an experiment designed to compare immersed versus ground 30-min cycling, thoracic electrical impedance was lower during recovery on land after exercising in water than on ground, which reflected a larger amount of thoracic fluid, while stroke volume was simultaneously lower, i.e. some degree of suboedema may have been present [4,6]. In addition, 20uC water carries a cold stress, even to an exercising subject [4,7,8], and even mild cooling increases peripheral vascular resistance, left ventricular afterload and pulmonary congestion [7]. Finally, symptoms related to pulmonary oedema occur earlier during sustained exercising in water than on land. In the case reported by WENGER and RUSSI [1] symptoms occured after 20 min, which matches other reports (see references quoted by WENGER and RUSSI [1], and also recently gathered data [9]). All in all, the occurrence of pulmonary oedema during various conditions of immersed exercising is not rare, which encourages efforts for a better understanding of the underlying pathophysiological mechanisms. Cardiovascular strains linked to sustained exercise during immersion should not be overlooked. Detailed recording of each case's circumstances of occurrence should aid recognition of recurrent features and tracking possible underlying pathways [9]. REFERENCES

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supporting

confidence: 78%

Section: To the Editorsmentioning

confidence: 69%

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Aqua jogging-induced pulmonary oedema

Regnard¹

2008

Eur Respir J

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“…Wenger and Russi ( 2007 ) published the only case of an aqua jogging-induced pulmonary edema. The diagnosis was made by the combination of chest-pressure, shortness of breath, expectoration of bloody froth and signs of pulmonary edema on the chest X-ray and chest CT.…”

Section: Resultsmentioning

confidence: 99%

Diagnosis of Swimming Induced Pulmonary Edema—A Review

Grünig

Nikolaidis²,

Moon

et al. 2017

Front. Physiol.

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Swimming induced pulmonary edema (SIPE) is a complication that can occur during exercise with the possibility of misdiagnosis and can quickly become life threatening; however, medical literature infrequently describes SIPE. Therefore, the aim of this review was to analyse all individual cases diagnosed with SIPE as reported in scientific sources, with an emphasis on the diagnostic pathways and the key facts resulting in its diagnosis. Due to a multifactorial and complicated pathophysiology, the diagnosis could be difficult. Based on the actual literature, we try to point out important findings regarding history, conditions, clinical findings, and diagnostic testing helping to confirm the diagnosis of SIPE. Thirty-eight cases from seventeen articles reporting the diagnosis of SIPE were selected. We found remarkable differences in the individual described diagnostic pathways. A total of 100% of the cases suffered from an acute onset of breathing problems, occasionally accompanied by hemoptysis. A total of 73% showed initial hypoxemia. In most of the cases (89%), an initial chest X-Ray or chest CT was available, of which one-third (71%) showed radiological signs of pulmonary edema. The majority of the cases (82%) experienced a rapid resolution of symptoms within 48 h, the diagnostic hallmark of SIPE. Due to a foreseeable increase in participation in swimming competitions and endurance competitions with a swimming component, diagnosis of SIPE will be important, especially for medical teams caring for these athletes.

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“…It was first described in the 1980s in healthy scuba divers (Wilmshurst et al., ). More recently, it has been described in open water swimmers (Beinart et al., ), triathletes (Deady et al., ; Spiteri et al., ; Casey et al., ), military trainees (Mahon et al., ; Adir et al., ; Knutson, ), and an aquajogger (Wenger & Russi, ). The incidence has been estimated as 1.1% among divers (Pons et al., ) and 1.8% among combat swimmers (Adir et al., ).…”

mentioning

confidence: 99%

A case of recurrent swimming‐induced pulmonary edema in a triathlete: the need for awareness

Smith

Brooke

Kipps

et al. 2016

Scandinavian Med Sci Sports

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This report discusses a rare case of a 55-year-old female triathlete who developed recurrent episodes of swimming-induced pulmonary edema (SIPE). She had two hospital admissions with pulmonary edema after developing breathlessness while swimming, including a near-drowning experience in an open water swim. With increasing popularity of triathlon and open water sports, this case highlights the importance of a greater awareness of SIPE among health professionals, event organizers, and athletes. This report explores the previous reported cases in triathletes and those who have suffered recurrent episodes. It is paramount that an accurate diagnosis is made as these individuals may be at an increased risk of future life-threatening episodes.

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Aqua jogging-induced pulmonary oedema

Cited by 14 publications

References 8 publications

Aqua jogging-induced pulmonary oedema

Aqua jogging-induced pulmonary oedema

Diagnosis of Swimming Induced Pulmonary Edema—A Review

A case of recurrent swimming‐induced pulmonary edema in a triathlete: the need for awareness

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