Kristi Ray, Sandra Williams, Stephen Morrical, Alejandro Garbino, Michelle Hong, Robert Sanders
Introduction: Pulmonary fluid shifts can occur while scuba diving. Such shifts, generally thought to be rare, may result in a life-threatening phenomenon known as immersion pulmonary edema (IPE). This study aims to better classify the normal physiology of diving using ultrasound (US) to determine if these fluid shifts occur routinely during commercial diving work at the NASA Neutral Buoyancy Laboratory (NBL). Methods: Chest US was performed on commercial divers prospectively pre- and post-dive to evaluate the presence of B-lines in a total of 12 intercostal points on the anterior, posterior, and lateral chest wall...
2020: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Laëtitia Corgie, Nicolas Huiban, Jean-Michel Pontier, François-Xavier Brocq, Jean-François Boulard, Marc Monteil
BACKGROUND: Scuba diving activities expose divers to serious accidents, which can require early hospitalization. Helicopters are used for early evacuation. On the French Mediterranean coast, rescue is made offshore mainly by a French Navy Dauphin or at a landing zone by an emergency unit EC 135 helicopter. METHODS: We retrospectively analyzed diving accidents evacuated by helicopter on the French Mediterranean coast from 1 September 2014 to 31 August 2016. We gathered data at the Center for Hyperbaric Medicine and Diving Expertise (SMHEP) of the Sainte-Anne Military Hospital (Toulon, France), the 35 F squadron at Hyres (France) Naval Air Station, and the SAMU 83 emergency unit (Toulon, France)...
October 1, 2020: Aerospace Medicine and Human Performance
David Szpilman, Paddy Morgan
Drowning is "the process of experiencing respiratory impairment from submersion or immersion in liquid". According to WHO, drowning claim the lives of more than 40 people every hour of every day. Drowning involves some physiological principles and medical interventions that are unique. It occurs in a deceptively hostile environment that involves an underestimation of the dangers or an overestimation of water competency. It has been estimated that more than 90% are preventable. When water is aspirated into the airways, coughing is the initial reflex response...
October 13, 2020: Chest
Brendan H A Milliner, Graham Brant-Zawadzki, Scott E McIntosh
INTRODUCTION: Cold-induced vasodilation (CIVD) is seen in the extremities during exposure to cold. A strong vasodilation response has been associated with a decreased risk of cold injury. Increasing CIVD might further decrease this risk. The calcium-channel blocker nifedipine causes vasodilation and is used to treat Raynaud's syndrome and chilblains. Nifedipine is also used for high altitude pulmonary edema and could potentially serve a dual purpose in preventing frostbite. The effects of nifedipine on CIVD have not been studied...
May 29, 2020: Wilderness & Environmental Medicine
Ruchi Yadav, Pramod Theetha Kariyanna, Dommalur Jayarangaiah, Delroy Thomas, Vivek Yadav, Ashkan Tadayoni, Lyudmila Aurora, Benjamin Ramalanjaona, Isabel M McFarlane
Swimming-induced pulmonary edema (SIPE), also called immersion pulmonary edema (IPE), is a medical condition seen in various water-based activities such as scuba diving, swimming, aqua jogging, triathlete competition and snorkeling. It occurs when transcapillary filtration of low protein fluid collects in the lungs, in the absence of water aspiration during an aquatic activity, causing acute dyspnea, cough and/or hemoptysis. The hallmark of this entity is the complete resolution of symptoms within 48 hours...
2020: American Journal of Medical Case Reports
Nobuhisa Morimoto, Madoka Tanabe, Atsuhiro Imono, Megumi Otani, Shingo Shioji, Suguru Hirasawa, Shota Aki, Makoto Aoyagi, Hiroyuki Tanaka
Immersion pulmonary edema (IPE) is a rare condition observed in divers. We report a case of a 66-year-old man on maintenance dialysis who developed acute dyspnea and blood-tinged sputum after scuba diving. Vital signs on admission were significant for elevated blood pressure at 209/63 mmHg and hypoxia with an oxygen requirement of 6 L/min. Physical examination was remarkable for bilateral coarse crackles and systolic ejection murmur. Chest radiography revealed bilateral pulmonary edema. Echocardiography showed aortic stenosis and diffuse hypokinesis of left ventricular wall motion...
March 13, 2020: Seminars in Dialysis
Anne Henckes, Guy Cochard, Florence Gatineau, Pierre Louge, Emmanuel Gempp, Sébastien Demaistre, Emmanuel Nowak, Yves Ozier
Background: Immersion can cause immersion pulmonary edema (IPE) in previously healthy subjects. We performed a case-control study to better identify IPE risk factors. Methods: We prospectively included recreational scuba divers who had presented signs of IPE and control divers who were randomly chosen among diving members of the French Underwater Federation. We sent an anonymous questionnaire to each diver, with questions on individual characteristics, as well as the conditions of the most recent dive (controls) or the dive during which IPE occurred...
September 2019: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Carl Edmonds, John Lippmann, Alfred Bove
Aim: To review incidents of immersion pulmonary edema (IPE) from Oceania, to determine the demographics, diving parameters, and comorbidities that may be related to this disorder. Method: Incidents of IPE, most of which were documented by Divers Alert Network Asia-Pacific (DAN AP) or reported in our medical literature, were analyzed. They included interviews with the survivors and a review of available medical records. Only incidents diagnosed as IPE by specialist diving physicians or pathologists with experience in the investigation of diving accidents were included...
September 2019: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Carl Edmonds, John Lippmann, Andrew Fock
Introduction: We aimed to document identified cases of immersion pulmonary edema (IPE) in divers from Oceania (the Indo-Pacific region) from January 2002 to May 2018, inclusive. Method: Cases were identified using various sources, including searches of the Divers Alert Network Asia-Pacific (DAN AP) Fatality Database, published case reports, and interviews with survivors who had reported their incident to DAN AP. Where available, investigations, pathology and autopsy results were obtained...
September 2019: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Richard E Moon
Immersion pulmonary (IPE, also known as swimming-induced pulmonary edema, SIPE) is a condition in which pulmonary edema develops rapidly during a dive or vigorous swim. Symptoms include dyspnea and hemoptysis. Physical exam reveals typical signs of bilateral pulmonary edema, which can be confirmed radiographically or with bedside ultrasound.
September 2019: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Fran de Asís Fernández, Lara Rodríguez-Zamora, Erika Schagatay
To facilitate recovery from hypoxia, many freedivers use a breathing method called "hook breathing" (HB) after diving, involving an interrupted exhale to build up intrapulmonary pressure. Some divers experience a delay in recovery of arterial oxygen saturation (SaO2 ) after diving, interpreted as symptoms of mild pulmonary edema, and facilitated recovery may be especially important in this group to avoid hypoxic "blackout." We examined the influence of HB on recovery of SaO2 in freedivers with slow recovery (SR) and fast recovery (FR) of SaO2 after deep "free immersion" (FIM) apnea dives to 30 m depth...
2019: Frontiers in Physiology
Brian M Keuski
This report summarizes some of the most relevant studies during the 2017-2018 academic year of scientific literature for diving medicine. The article selection is the result of a PubMed search for "diving," as well as a manual review of the journals Undersea and Hyperbaric Medicine and Diving and Hyperbaric Medicine. Four articles were published reporting on new advances in decompression modeling. New consensus guidelines in the prehospital treatment of decompression sickness were published as well as a retrospective review of the efficacy of the U...
September 2018: Undersea & Hyperbaric Medicine: Journal of the Undersea and Hyperbaric Medical Society, Inc
Manish Kumar, Paul D Thompson
IMPORTANCE: Immersion pulmonary edema (IPE) is a rare but important complication associated with surface swimming and underwater diving. It tends to reoccur and can be fatal. It is not very well-known to clinicians involved in the care of individuals participating in aquatic activities. We performed a systematic review of immersion pulmonary edema to describe the condition and provide guidelines for its management. EVIDENCE REVIEW: We searched PubMed to identify case reports and studies using the MeSH terms "immersion," "pulmonary edema," "cold-induced," "exercise," "hemodynamics," "water immersion,'' "cardiovascular response," alone and in combinations...
May 2019: Physician and Sportsmedicine
Ralph Smith, Julian O M Ormerod, Nikant Sabharwal, Courtney Kipps
With the growing popularity of water-based sports, cases of swimming-induced pulmonary edema (SIPE) are becoming increasingly recognized. SIPE, a potentially life-threatening condition, is an acute cause of breathlessness in athletes. It has been described frequently in scuba divers, swimmers, and triathletes and is characterized by symptoms and signs of pulmonary edema following water immersion. It is important to recognize that athletes' symptoms can present with a spectrum of severity from mild breathlessness to severe dyspnea, hemoptysis, and hypoxia...
2018: Open Access Journal of Sports Medicine
Peter Lindholm, Erik R Swenson, Santiago Martínez-Jiménez, H Henry Guo
No abstract text is available yet for this article.
October 15, 2018: American Journal of Respiratory and Critical Care Medicine
W Liu, J K Chai
Objective: To explore the influences of ulinastatin on acute lung injury and time phase changes of coagulation parameters in rats with severe burn-blast combined injuries. Methods: One hundred and ninety-two Sprague-Dawley rats were divided into pure burn-blast combined injury group, ulinastatin+ burn-blast combined injury group, and sham injury group according to the random number table, with 64 rats in each group. Two groups of rats with combined burn-blast injuries were inflicted with moderate blast injuries with the newly self-made explosive device...
January 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Olivier Castagna, Jacques Regnard, Emmanuel Gempp, Pierre Louge, François Xavier Brocq, Bruno Schmid, Anne-Virginie Desruelle, Valentin Crunel, Adrien Maurin, Romain Chopard, David Hunter MacIver
BACKGROUND: Immersion pulmonary edema is potentially a catastrophic condition; however, the pathophysiological mechanisms are ill-defined. This study assessed the individual and combined effects of exertion and negative pressure breathing on the cardiovascular system during the development of pulmonary edema in SCUBA divers. METHODS: Sixteen male professional SCUBA divers performed four SCUBA dives in a freshwater pool at 1 m depth while breathing air at either a positive or negative pressure both at rest or with exercise...
January 3, 2018: Sports Medicine—Open
A Boussuges, K Ayme, G Chaumet, E Albier, M Borgnetta, O Gavarry
BACKGROUND: The risk factors of pulmonary edema induced by diving in healthy subjects are not well known. The aim of the present study was to assess the parameters contributing to the increase in extravascular lung water after diving. METHODS: This study was carried out in a professional diving institute. All divers participating in the teaching program from June 2012 to June 2014 were included in the study. Extravascular lung water was assessed using the detection of ultrasound lung comets (ULC) by chest ultrasonography...
October 3, 2017: Sports Medicine—Open
Benoît Desgraz, Claudio Sartori, Mathieu Saubade, Francis Héritier, Vincent Gabus
Immersion pulmonary edema may occur during scuba diving, snorke-ling or swimming. It is a rare and often recurrent disease, mainly affecting individuals aged over 50 with high blood pressure. However it also occurs in young individuals with a healthy heart. The main symptoms are dyspnea, cough and hemoptysis. The outcome is often favorable under oxygen treatment but deaths are reported. A cardiac and pulmonary assessment is necessary to evaluate the risk of recurrence and possible contraindications to immersion...
July 12, 2017: Revue Médicale Suisse
Julie Vinkel, Peter Bak, Peter Juel Thiis Knudsen, Ole Hyldegaard
Immersion Pulmonary Edema (IPE) reduces the transport of gases over the respiratory membrane due to edema in the interstitium and respiratory zones. IPE has previously been described in both swimmers and divers, with a few known fatal cases. We have reviewed 42 SCUBA and snorkeling-related drowning deaths, and through a thorough analysis of each case, including both diving physiology and forensic pathology, we present IPE as a differential diagnosis to drowning in four cases. Our findings propose that; absence of watery content in the stomach and conducting airways, and liquid filled lungs without hyperexpansion, may be compatible with IPE...
January 2018: Journal of Forensic Sciences
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