Immersion Pulmonary Edema and Comorbidities

Peacher, Dionne F.; Martina, Stefanie; Otteni, C; Wester, Tracy E.; Potter, Michael Q.; Moon, Richard E.

doi:10.1249/mss.0000000000000524

Cited by 64 publications

(79 citation statements)

References 49 publications

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“…Peacher et al 17 retrospectively studied 36 participants who experienced swimming-related pulmonary edema, and determined that 72.2% of those who sustained an immersion pulmonary edema event had one or more significant medical conditions (risk factors) at the time of the event compared with only 44.9% in historical controls (p<0.001). The participants for this study were initially recruited for another purpose, and the cases compared using historical controls.…”

Section: Resultsmentioning

confidence: 99%

“…Although there are only a small number of lower quality studies, there does appear to be some support that symptoms of SIPE do occur during triathlon or open-water swimming, however, none of these studies has specifically identified SIPE as a cause of swimming-related death. People more likely to have symptoms of SIPE had more than one significant medical condition, such as hypertension 17 20. These symptoms were more likely to occur in longer events and to females 20.…”

Section: Discussionmentioning

confidence: 99%

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Hypothesised mechanisms of swimming-related death: a systematic review

Asplund

Creswell

2016

Br J Sports Med

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The available evidence is limited but may suggest that cardiac arrhythmias are the most likely aetiology of swimming-related death. While symptoms of pulmonary edema may occur during swimming, current evidence does not support swimming-induced pulmonary edema as a frequent cause of swimming-related death, nor is there evidence to link hypothermia or hyperthermia as a causal mechanism. Further higher level studies are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hypothesised mechanisms of swimming-related death: a systematic review

Asplund

Creswell

2016

Br J Sports Med

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“…Auscultation reveals bibasilar rales, with a pulmonary oedema pattern seen on the chest radiograph. The disorder is transient and clears on chest radiography in 7 days [45]. It is common to find decreased forced vital capacity and forced expiratory volume in 1 s, and increased levels of brain natriuretic peptide (indicative of left ventricle strain) after the oedema is resolved [46].…”

Section: Noncardiogenic Oedema and Haemoptysismentioning

confidence: 99%

Sports-related lung injury during breath-hold diving

Mijačika

Dujić

2016

Eur Respir Rev

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The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage. @ERSpublications Breath-hold diving may result in acute respiratory symptoms, but does not lead to chronic lung dysfunction http://ow.ly/D03r302uMOD

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“…Edema-prone individuals demonstrated a lower total lung tissue mass and thinner lung septae. Gempp et al 28 found that individuals prone to IPE demonstrated a high incidence of hypertension, and Peacher et al 29 reported a variety of common clinical comorbidities in 70% of individuals who showed evidence of IPE while diving (Table 1).…”

Section: Swimming-induced Pulmonary Edemamentioning

confidence: 99%

Pulmonary Aspects of Exercise and Sports

Bové

2016

Methodist DeBakey Cardiovascular Journal

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Although the lungs are a critical component of exercise performance, their response to exercise and other environmental stresses is often overlooked when evaluating pulmonary performance during high workloads. Exercise can produce capillary leakage, particularly when left atrial pressure increases related to left ventricular (LV) systolic or diastolic failure. Diastolic LV dysfunction that results in elevated left atrial pressure during exercise is particularly likely to result in pulmonary edema and capillary hemorrhage. Data from race horses, endurance athletes, and triathletes support the concept that the lungs can react to exercise and immersion stress with pulmonary edema and pulmonary hemorrhage. Immersion in water by swimmers and divers can also increase stress on pulmonary capillaries and result in pulmonary edema. Swimming-induced pulmonary edema and immersion pulmonary edema in scuba divers are well-documented events caused by the fluid shifts that occur with immersion, elevated pulmonary venous pressure during extreme exercise, and negative alveolar pressure due to inhalation resistance. Prevention strategies include avoiding extreme exercise, avoiding over hydration, and assuring that inspiratory resistance is minimized. Figure 1. Pulmonary capillary wedge pressure (PCWP) measured during increasing exercise intensity, determined by oxygen consumption (VO 2 ), in well-trained (circles) and average-trained (squares) men with a mean age of 29.6. Note that the well-trained subjects preserved normal levels of PCWP until they reached high levels of exercise, while the average-trained men demonstrated increases in PCWP at lower levels of exercise intensity. Adapted from Stickland et al. 4MDCVJ | XII (2) 2016 94 houstonmethodist.org/debakey-journal of interstitial hemorrhage and fluid accumulation following a high workload in one horse that developed EIPH. West et al. 9 suggested that two factors contributed to this problem in horses: (1) They were likely to have a congenital weakness of pulmonary capillaries that resulted in capillary rupture at high pulmonary venous and capillary pressure, and (2) they developed high pulmonary venous pressure due to failure of the left ventricle with subsequent elevation of LV end diastolic pressure during high workloads.Human studies of lung responses to high workloads 10 corroborate the studies of West et al. to some extent. Zavorsksy et al. 11 studied individuals under several different workloads and performed lung imaging to document the presence or absence of lung edema. Radiographic image readers were blinded to the exposures and reported visual evidence of lung fluid. In individuals undergoing a diagnostic graded exercise test, no evidence of lung edema was noted. However, 15% of individuals who ran on a treadmill at 70% of maximum capacity for 2 hours demonstrated evidence of pulmonary edema, as did 65% of those who ran at maximum capacity for 7 minutes. Similar findings were noted in female athletes.12 Pingitore et al. examined 48 athletes before and aft...

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Immersion Pulmonary Edema and Comorbidities

Cited by 64 publications

References 49 publications

Hypothesised mechanisms of swimming-related death: a systematic review

Hypothesised mechanisms of swimming-related death: a systematic review

Sports-related lung injury during breath-hold diving

Pulmonary Aspects of Exercise and Sports

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