Lung injury related to extreme environments

Adir, Yochai; Bové, Alfred A.

doi:10.1183/09059180.00006214

Cited by 11 publications

(12 citation statements)

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“…For example, in susceptible individuals pulmonary oedema may result from capillary stress failure when performing strenuous exercise in the immersed state, in particular during cold water immersion [11].…”

Section: Diving Exposurementioning

confidence: 99%

Short- and long-term effects of diving on pulmonary function

Tetzlaff

Thomas

2017

Eur Respir Rev

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@ERSpublicationsThe effects of diving on pulmonary function largely depend on factors associated with the individual diving response http://ow.ly/aIFS3095WNnCite this article as: Tetzlaff K, Thomas PS. Short-and long-term effects of diving on pulmonary function. ABSTRACT The diving environment provides a challenge to the lung, including exposure to high ambient pressure, altered gas characteristics and cardiovascular effects on the pulmonary circulation. Several factors associated with diving affect pulmonary function acutely and can potentially cause prolonged effects that may accumulate gradually with repeated diving exposure. Evidence from experimental deep dives and longitudinal studies suggests long-term adverse effects of diving on the lungs in commercial deep divers, such as the development of small airways disease and accelerated loss of lung function. In addition, there is an accumulating body of evidence that diving with self-contained underwater breathing apparatus (scuba) may not be associated with deleterious effects on pulmonary function. Although changes in pulmonary function after single scuba dives have been found to be associated with immersion, ambient cold temperatures and decompression stress, changes in lung function were small and suggest a low likelihood of clinical significance. Recent evidence points to no accelerated loss of lung function in military or recreational scuba divers over time. Thus, the impact of diving on pulmonary function largely depends on factors associated with the individual diving exposure. However, in susceptible subjects clinically relevant worsening of lung function may occur even after single shallow-water scuba dives.

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Section: Diving Exposurementioning

confidence: 99%

Short- and long-term effects of diving on pulmonary function

Tetzlaff

Thomas

2017

Eur Respir Rev

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“…These events may occur during ascent or descent [31] and often occur in divers who perform GPI [26]. For detailed aspects of pulmonary barotrauma see other reports [32].…”

Section: Pulmonary Barotraumamentioning

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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“…This feature has been taken into account in the recent definition of ARDS [18]. ADIR and BOVE [1] discuss negative pressure pulmonary oedema (NPPE) in scuba diving and mention that it has also been reported in the field of anaesthesiology in patients with fixed and complete upper airway obstruction. Two mechanisms may explain NPPE and have been reviewed recently [19].…”

mentioning

confidence: 99%

“…ADIR and BOVE [1] mention the stress capillary failure, initially described by WEST et al [14], as breaks in the alveolar-to-capillary membrane due to high hydrostatic lung microvascular pressure resulting from high cardiac output, which is achieved during intense exercise. Stress capillary failure has many implications in the ICU.…”

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confidence: 99%

“…Stress capillary failure has many implications in the ICU. First in the pathogenesis of high-altitude pulmonary oedema and neurogenic oedema, as underlined by ADIR and BOVE [1], and secondly in the pathophysiology of VILI. DREYFUSS and SAUMON [15] found similar alveolar-to-capillary membrane disruptions in rats with previously normal lungs who were receiving a large tidal volume during positive pressure mechanical ventilation.…”

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confidence: 99%

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