Swimming-Induced Pulmonary Edema

Adir, Yochai; Shupak, Avi; Gil, Amnon; Peled, Nir; Keynan, Yoav; Domachevsky, Liran; Weiler-Ravell, Daniel

doi:10.1378/chest.126.2.394

Cited by 119 publications

(86 citation statements)

References 30 publications

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“…Five prospective incidence studies met the inclusion criteria; three of male Israeli military trainees aged 18–19 carrying out 2.4–3.6 km swimming time trials in the open-sea [12–14], one of competitors of 1–3 km swimming races in a Swedish river [15] and one of triathletes competing in UK triathlons with a 0.4–1.5 km swim [16] (see Table 1). The military trainee swimming trial studies took place over a period of 3 years, 2 months and 1 day respectively [12–14].…”

Section: Resultsmentioning

confidence: 99%

“…The military trainee swimming trial studies took place over a period of 3 years, 2 months and 1 day respectively [12–14]. Braman Eriksson et al [15] carried out their study over 3 days at the Vansbrosimningen 2016 swimming event.…”

Section: Resultsmentioning

confidence: 99%

“…0.5% ( n = 69) of races swumPatient symptoms and clinical findings were not recorded. No information on competitors that did not seek medical attentionAdir et al [12]Prospective incidence studyMilitary trainees (Israeli Navy)Unknown number of males aged 18–19 in swimming trials of 2.4–3.6 km distance (average of 30–45 min duration) in 1998–2001Open sea of varying temperatures (19.6 °C ± 3.2), no wetsuits, supine semi-reclining position with finsSevere shortness of breath and coughing during or after swimming in the absence of sea aspiration, and evidence of PE found on medical examinationInterview and clinical examination of swimmers presenting to medical team1.8% ( n = 70) of swimming trials performedUnknown total number of swimmers and time trials. Unclear number of new cases versus recurrencesShupak et al [13]Prospective incidence studyMilitary trainees (Israeli Navy)35 males aged 18–19 performing 5 swimming trials (2.4–3.6 km) over 2 months (mid-Jan to mid-Mar).…”

Section: Resultsmentioning

confidence: 99%

“…Different methods were used for calculating the rate of incidence. For example, some authors used the total number of swimmers as the denominator [13, 14], whereas others used the total number of swims [12, 15, 16]. …”

Section: Resultsmentioning

confidence: 99%

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Occurrence, Risk Factors, Prognosis and Prevention of Swimming-Induced Pulmonary Oedema: a Systematic Review

2018

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BackgroundSwimming-induced pulmonary oedema (SIPE) can affect people with no underlying health problems, but may be life threatening and is poorly understood. The aim of this systematic review was to synthesise the evidence on SIPE incidence, prevalence, risk factors, short- and long-term outcomes, recurrence and effectiveness of interventions to prevent recurrences.MethodsWe carried out a literature search using bibliographic databases and reference lists. Risk of bias was assessed by adapting existing quality assessment tools including those developed by the National Heart Lung and Blood Institute.ResultsNine studies met the inclusion criteria. Quantitative synthesis was not possible because of study heterogeneity. Five studies, which differed from each other in case definition, swimming environment, population characteristics and denominators, reported an incidence of 0.01% of UK triathlons raced over 5 years in unspecified swimming environments (one study, not fully reported, of men and women of unspecified age); 0.5% of river races swum over 3 days in Sweden (one study, of men and women up to the age of 70); and 1.8–26.7% of time trials in the sea around Israel (three studies of male teenage military trainees). One study reported that 1.4% of triathletes in the USA had experienced SIPE. One study found that hypertension, female sex, fish oil use, long course distance and another lower initial lung volumes and flows were risk factors for SIPE. A third study reported that higher mean pulmonary artery pressures and pulmonary artery wedge pressures, and lower tidal volumes were associated with SIPE. Three studies suggested that SIPE symptoms usually resolve within 24 h, although a restrictive deficit in lung function persisted for a week in one small study. We found no studies that reported deaths from SIPE. The single small study of longer-term outcomes reported no difference between affected and unaffected swimmers. Two studies suggested that around 30% of people report recurrences of SIPE. Two very small uncontrolled studies of the effect of sildenafil for recurrence prevention were inconclusive.ConclusionsSIPE may be an important public health problem affecting the growing number of recreational open water swimmers. Further research should clarify the frequency of SIPE among recreational open water swimmers, confirm reported risk factors and explore others, explore long-term consequences and test interventions to prevent recurrences.Electronic supplementary materialThe online version of this article (10.1186/s40798-018-0158-8) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Occurrence, Risk Factors, Prognosis and Prevention of Swimming-Induced Pulmonary Oedema: a Systematic Review

2018

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“…22 A recent questionnaire evaluation indicated a prevalence of approximately 1-2% in triathletes. 23 The phenomenon has been reported to be temporally associated with factors detrimental to cardiac loading, including coldwater exposure, wearing a wetsuit and excessive hydration before swimming.…”

Section: Exercise-induced Pulmonary Oedemamentioning

confidence: 99%

Managing respiratory problems in athletes

et al. 2012

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-Respiratory problems are common in athletes of all abilities and can significantly impact upon their health and performance. In this article, we provide an overview of respiratory physiology in athletes. We also discuss the assessment and management of common clinical respiratory conditions as they pertain to athletes, including airways disease, respiratory tract infection and pneumothorax. We focus on providing a pragmatic approach and highlight important caveats for the physician treating respiratory conditions in this highly specific population.

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Severe immersion pulmonary edema in a novice elderly scuba diver after heavy alcohol intake

Morimatsu

Nasu²,

Murata³

et al. 2021

Acute Medicine & Surgery

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Background: There are no reports of immersion pulmonary edema induced by excessive alcohol intake. We describe the case of a novice scuba diver who developed apnea due to immersion pulmonary edema during scuba diving after heavy alcohol intake.Case Presentation: A 71-year-old hypertensive man, without regular antihypertensive therapy, performed diving after excessive alcohol intake (total amount, approximately 253 g) until the night before. When swimming at a depth of 12 m, the patient experienced chest discomfort and ascended immediately but became unconscious. Respiratory arrest was confirmed, and he spat pink foamy sputum. On hospital admission, hypoxemia was confirmed, and chest radiography revealed butterfly-shaped shadows. Therefore, mechanical ventilation was initiated. The next day, his blood oxygenation level improved, and the radiographic shadows disappeared. He was discharged on day 7 of hospitalization without sequelae. Conclusion:A scuba diver with untreated hypertension might develop immersion pulmonary edema during diving after heavy alcohol intake.

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Swimming-Induced Pulmonary Edema

Cited by 119 publications

References 30 publications

Occurrence, Risk Factors, Prognosis and Prevention of Swimming-Induced Pulmonary Oedema: a Systematic Review

Occurrence, Risk Factors, Prognosis and Prevention of Swimming-Induced Pulmonary Oedema: a Systematic Review

Managing respiratory problems in athletes

Severe immersion pulmonary edema in a novice elderly scuba diver after heavy alcohol intake

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