Cardiopulmonary Function After Recovery From Swimming-induced Pulmonary Edema

Ludwig, B; Mahon, Richard T.; Schwartzman, Eric

doi:10.1097/00042752-200607000-00011

Cited by 32 publications

(46 citation statements)

References 16 publications

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“…These observations were confirmed in a series of previously healthy individuals, who developed lung oedema during diving or swimming [2]. Since the studies of WILSMHURST et al [1] and PONS et al [2], 36 healthy individuals have been reported in medical literature to have developed pulmonary oedema while scuba-diving and 121 persons have developed it during swimming [3][4][5][6][7][8]. In view of the fact that such events occur sporadically and are not reproducible under experimental conditions, the underlying pathophysiology remains elusive.…”

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confidence: 67%

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Aqua jogging-induced pulmonary oedema

Wenger

Russi²

2007

European Respiratory Journal

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The present study reports the case of a 43-yr-old very sporty male, who developed shortness of breath and expectorated bloody froth during aqua jogging. Pulmonary oedema was diagnosed clinically and by computed tomography of the chest. The patient made a full recovery and his echocardiography was entirely normal.Pulmonary oedema occurring in healthy scuba-divers and swimmers has been reported previously. However, this is the first case where pulmonary oedema was observed during aqua jogging.

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confidence: 67%

“…Since the first studies of pulmonary oedema in healthy swimmers and divers [1,2], such observations have been made by other groups worldwide [3][4][5][6][7][8]. However, considering the popularity of both scuba-diving and swimming, such episodes remain a remarkably rare event.…”

Section: Discussionmentioning

confidence: 99%

Aqua jogging-induced pulmonary oedema

Wenger

Russi²

2007

European Respiratory Journal

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“…Individual contribution of each of these factors varies depending on the exposure. While clear evidence of cardiac and pulmonary abnormalities have not been found [82], individual variation in susceptibility [8,83] due either to variations in capillary strength, left ventricular relaxation, pulmonary vascular reactivity under conditions of exercise, and the instantaneous state of blood and fluid volume are likely to contribute to the development of pulmonary oedema.…”

Section: Discussionmentioning

confidence: 99%

Lung injury related to extreme environments

Adir

Bové

2014

Eur Respir Rev

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@ERSpublications Lung injury is a well understood and preventable consequence of water immersion while swimming and diving http://ow.ly/AOdvgAs extreme sports become more popular, related respiratory injury may compromise the athlete's performance and result in morbidity and even mortality. In this article we will discuss different lung injuries in relation to performing different activities in an extreme environment. Hydrostatic lung injuriesThe evolution of fish to amphibians, reptiles to endothermic birds and mammals has been accompanied by a progressively thinner pulmonary blood gas barrier, to accommodate the constraint of increased oxygen uptake and carbon dioxide output [1]. Accordingly, pulmonary circulation has evolved as a separate high flow-low pressure system. In humans, mean pulmonary artery pressures (PAP) are 8-20 mmHg, pulmonary wedge pressures are 5-14 mmHg and pulmonary capillary pressures are 8-12 mmHg [2]. A low-pressure regimen preserves the integrity of an alveolar capillary membrane only 0.3 mm thick. However, this structure is vulnerable to increased pressures during strenuous exercise or environmental hypoxic exposure as a cause of stress failure of the pulmonary capillaries and accumulation of extravascular lung water [3]. Reports of lung injury related to extremes of exercise and variations in ambient pressure and altitude confirm this vulnerability. The resulting lung injury takes the form of noncardiogenic pulmonary oedema.The occurrence of noncardiogenic pulmonary oedema and pulmonary haemorrhage has been described in relation to a variety of disorders related to auto-and exogenous immunological reactions, infections and certain inhalants. However, numerous reports of lung injury manifesting as pulmonary oedema with associated haemorrhage have been described more recently in relation to immersion underwater, swimming, extreme exercise and exposure to altitude. In addition, pulmonary oedema resulting from negative intra-alveolar pressure has been described in the anaesthesia literature and may play a role in exercise-and immersion-induced pulmonary oedema. Haemodynamically induced pulmonary oedemaA single mechanism responsible for production of noncardiogenic pulmonary oedema related to immersion, altitude and exercise has not been identified. However, a combination of haemodynamically related factors, alterations in capillary integrity, increased blood volume and increased cardiac output may all contribute to the syndrome. WEST et al.[4] described exercise-induced pulmonary haemorrhage in race For editorial comments see page 401.

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“…The exact pathophysiology of the immersion oedema and possible risk factors are still largely unknown. Bronchoalveolar lavage analysis ruled out an inflammatory process as the background for the development of oedema [38]. The prevailing theory claims that several factors, such as increased intrathoracic blood volume and cardiac output, increased pulmonary vasoconstriction and an individually smaller pulmonary lymphatic network contribute to increased hydrostatic pressure that leads to pulmonary capillary stress failure [38,39].…”

Section: Noncardiogenic Oedema and Haemoptysismentioning

confidence: 99%

“…Bronchoalveolar lavage analysis ruled out an inflammatory process as the background for the development of oedema [38]. The prevailing theory claims that several factors, such as increased intrathoracic blood volume and cardiac output, increased pulmonary vasoconstriction and an individually smaller pulmonary lymphatic network contribute to increased hydrostatic pressure that leads to pulmonary capillary stress failure [38,39]. High pulmonary vascular pressure occurs during immersion as a result of a central blood volume shift, augmented by active vasoconstriction in cold water and the diving reflex [40].…”

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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Cardiopulmonary Function After Recovery From Swimming-induced Pulmonary Edema

Cited by 32 publications

References 16 publications

Aqua jogging-induced pulmonary oedema

Aqua jogging-induced pulmonary oedema

Lung injury related to extreme environments

Sports-related lung injury during breath-hold diving

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