Ultrasound lung “comets” increase after breath-hold diving

Lambrechts, Kate; Germonpré, Peter; Charbel, Brian; Cialoni, Danilo; Musimu, Patrick; Sponsiello, Nicola; Marroni, Alessandro; Pastouret, Frédéric; Balestra, Costantino

doi:10.1007/s00421-010-1697-y

Cited by 19 publications

(20 citation statements)

References 29 publications

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“…In our study, the increase in pulmonary blood flow experienced by underwater fishermen may have been further increased by vigorous swimming to catch fish. The contribution of swimming in the increase in EVLW has been demonstrated recently by the work of Lambrechts et al (2011). They observed an increase in the ULC scores after shallow dynamic apneas, whereas non maximal static apneas did not induce an increase in ULC.…”

Section: Discussionmentioning

confidence: 59%

Ultrasound lung comets induced by repeated breath‐hold diving, a study in underwater fishermen

Boussuges¹,

Coulange²,

Bessereau³

et al. 2011

Scandinavian Med Sci Sports

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Pulmonary edema has been reported in breath-hold divers during fish-catching diving activity. The present study was designed to detect possible increases in extravascular lung water (EVLW) in underwater fishermen after a competition. Thirty healthy subjects were studied. They participated in two different 5-h fish-catching diving competitions: one organized in the winter (10 subjects) and one organized in the autumn (20 subjects). A questionnaire was used to record underwater activity and note respiratory problems. An increase in EVLW was investigated from the detection of ultrasound lung comets (ULC) by chest ultrasonography. Complementary investigations included echocardiography and pulmonary function testing. An increase in EVLW was detected in three out of 30 underwater fishermen after the competition. No signs of cardiovascular dysfunction were found in the entire population and in divers with an increase in the ULC score. Two divers with raised ULC presented respiratory disorders such as cough or shortness of breath. Impairment in spirometric parameters was recorded in these subjects. An increase in EVLW could be observed after a fish-catching diving competition in three out of 30 underwater fishermen. In two subjects, it was related to respiratory disorders and impairment in pulmonary flow.

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Section: Discussionmentioning

confidence: 59%

Ultrasound lung comets induced by repeated breath‐hold diving, a study in underwater fishermen

Boussuges¹,

Coulange²,

Bessereau³

et al. 2011

Scandinavian Med Sci Sports

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“…ULCs are accurate in detecting cardiogenic pulmonary edema, correlating with NH 2 -terminal pro-brain natriuretic peptide (NT-proBNP) (14), and in predicting prognosis of patients with dyspnea and/or chest pain syndrome (10). Finally, ULCs have also been shown in healthy subjects at high altitude and in breath-hold divers (11,22,35).We hypothesized that increase in pulmonary water content may occur in healthy athletes performing strenuous exercise at sea level consisting of Ironman triathlon (3.8 km swimming, 180 km cycling, and 42 km running). …”

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confidence: 97%

Early subclinical increase in pulmonary water content in athletes performing sustained heavy exercise at sea level: ultrasound lung comet-tail evidence

Pingitore

Garbella

Piaggi³

et al. 2011

American Journal of Physiology-Heart and Circulatory Physiology

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Gemignani A, L=Abbate A. Early subclinical increase in pulmonary water content in athletes performing sustained heavy exercise at sea level: ultrasound lung comet-tail evidence. Am J Physiol Heart Circ Physiol 301: H2161-H2167, 2011. First published August 26, 2011; doi:10.1152/ajpheart.00388.2011.-Whether prolonged strenuous exercise performed by athletes at sea level can produce interstitial pulmonary edema is under debate. Chest sonography allows to estimate extravascular lung water, creating ultrasound lung comet-tail (ULC) artifacts. The aim of the study was to determine whether pulmonary water content increases in Ironmen (n ϭ 31) during race at sea level and its correlation with cardiopulmonary function and systemic proinflammatory and cardiac biohumoral markers. A multiple factor analysis approach was used to determine the relations between systemic modifications and ULCs by assessing correlations among variables and groups of variables showing significant pre-post changes. All athletes were asymptomatic for cough and dyspnea at rest and after the race. Immediately after the race, a score of more than five comet tail artifacts, the threshold for a significant detection, was present in 23 athletes (74%; 16.3 Ϯ 11.2; P Ͻ 0.01 ULC after the race vs. rest) but decreased 12 h after the end of the race (13 athletes; 42%; 6.3 Ϯ 8.0; P Ͻ 0.01 vs. soon after the race). Multiple factor analysis showed significant correlations between ULCs and cardiac-related variables and NH2-terminal pro-brain natriuretic peptide. Healthy athletes developed subclinical increase in pulmonary water content immediately after an Ironman race at sea level, as shown by the increased number of ULCs related to cardiac changes occurring during exercise. Hemodynamic changes are one of several potential factors contributing to the mechanisms of ULCs. pulmonary edema EVEN IN HEALTHY SUBJECTS EXTREMELY demanding endurance exercise leads to functional and structural cardiac and pulmonary changes, along with local and systemic responses, reflecting oxidative, metabolic, hormonal, and thermal stress, besides immunomodulation and inflammatory reaction (4,30,32,40,41,46). Whether interstitial pulmonary edema occurs in athletes performing heavy sea level exercise is debated (2,6,12,18,19,27,28,44,56). Interstitial pulmonary edema has been documented in endurance athletes performing heavy sea level exercise, using imaging techniques such as chest X-ray, magnetic resonance, computed tomography, and scintigraphy (17,36,56). Previous authors measured noninvasively the postexercise extracellular thoracic fluid volume using thoracic impedance monitoring (16). However, this method does not allow visualizing the seat of the water content in the chest. Chest sonography can be used in the field for assessment of athletes immediately after the end of exercise (11,34,35). This technique effectively detects and quantifies extravascular lung water, creating ultrasound lung comet-tail (ULC) artifacts from water-thickened pulmonary interlobular septa (11). In a pi...

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“…2,3 According to an earlier notion-now outdated-the maximum safe depth limit is determined by the ratio between the total lung capacity (TLC) and the residual volume (RV) with a TLC of 6 L and a RV of 1.2 L, yields a ratio of 5, which in turn implies a maximum safe depth of only 40 m (=5 bar). At greater depths, intrathoracic pressure would become smaller than ambient pressure, resulting in pulmonary edema and hemorrhage, 4,5 and alveolar collapse. 6,7 Nevertheless, depending on the discipline, records with depths >100 m are not uncommon today.…”

Section: Introductionmentioning

confidence: 99%