Pulmonary edema after competitive breath-hold diving

Linér, Mats H.; Andersson, Johan

doi:10.1152/japplphysiol.00641.2007

Cited by 37 publications

(30 citation statements)

References 26 publications

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“…It has been reported previously that an increase in ambient pressure secondary to the descent toward the bottom could promote pulmonary disorders such as hemoptysis or pulmonary edema in competitive apnea divers (Fitz‐Clarke, 2006; Frassi et al, 2008; Liner & Andersson, 2008). In our study, the incidence of respiratory disorders and signs of increase in EVLW (3/30 underwater fishermen) were lower than in the study of Liner and Andersson (2008) (6/19 competitive apnea divers) as well as that of Frassi et al (2008) (14/31 competitive apnea divers). Furthermore, although a decrease in FEV 1.0 was found in underwater fishermen suffering from respiratory disorders, no significant difference was found in FEV 1.0 in the entire population after the competition in comparison with the baseline.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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 also been suggested to occur in shallow water breath-hold dives with low lung volume (59), but only in deep dives, compared with shallow dives, when the lungs are inflated (60).…”

Section: Respiratory Functionmentioning

confidence: 99%

“…Similarly, too deep a breath-hold dive can lead to "lung squeeze" with hemorrhage and possibly pulmonary edema (59,60). By contrast, as long as a diver is breathing on a diving apparatus, breathing gas is provided at essentially the same pressure as the water pressure on the chest.…”

Section: Respiratory Functionmentioning

confidence: 99%

The underwater environment: cardiopulmonary, thermal, and energetic demands

Pendergast¹,

Lundgren²

2009

Journal of Applied Physiology

131

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Pendergast DR, Lundgren CE. The underwater environment: cardiopulmonary, thermal, and energetic demands. J Appl Physiol 106: 276 -283, 2009. First published November 26, 2008 doi:10.1152/japplphysiol.90984.2008.-Water covers over 75% of the earth, has a wide variety of depths and temperatures, and holds a great deal of the earth's resources. The challenges of the underwater environment are underappreciated and more short term compared with those of space travel. Immersion in water alters the cardio-endocrine-renal axis as there is an immediate translocation of blood to the heart and a slower autotransfusion of fluid from the cells to the vascular compartment. Both of these changes result in an increase in stroke volume and cardiac output. The stretch of the atrium and transient increase in blood pressure cause both endocrine and autonomic changes, which in the short term return plasma volume to control levels and decrease total peripheral resistance and thus regulate blood pressure. The reduced sympathetic nerve activity has effects on arteriolar resistance, resulting in hyperperfusion of some tissues, which for specific tissues is time dependent. The increased central blood volume results in increased pulmonary artery pressure and a decline in vital capacity. The effect of increased hydrostatic pressure due to the depth of submersion does not affect stroke volume; however, a bradycardia results in decreased cardiac output, which is further reduced during breath holding. Hydrostatic compression, however, leads to elastic loading of the chest wall and negative pressure breathing. The depthdependent increased work of breathing leads to augmented respiratory muscle blood flow. The blood flow is increased to all lung zones with some improvement in the ventilation-perfusion relationship. The cardiac-renal responses are time dependent; however, the increased stroke volume and cardiac output are, during head-out immersion, sustained for at least hours. Changes in water temperature do not affect resting cardiac output; however, maximal cardiac output is reduced, as is peripheral blood flow, which results in reduced maximal exercise performance. In the cold, maximal cardiac output is reduced and skin and muscle are vasoconstricted, resulting in a further reduction in exercise capacity. respiratory; renal; immersion; exercise; aging; sex differences; submersion; pressure; energy cost THE UNDERWATER ENVIRONMENT is unique, and while it is a magical place with great history and beauty and plant and animal life and holds a wealth of resources, it also imposes pronounced physiological stresses on humans and animals. This brief review offers an overview of how the major environmental challenges, i.e., the pressure, temperature extremes, and the unbreathable ambient medium, of the "Silent World" affect circulation, renal system and water balance, breathing, exercise, and thermal balance and how it imposes some threats due to pharmacological or toxic effects of respired gases at high pressure, i.e., great depths. Adaptations to ...

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“…As a fi nal point, West et al ( 17 ) state that both an increase in capillary pressure and high states of lung infl ation are important factors for stress failure of pulmonary capillaries. Thus, the possible association between pulmonary overinfl ation by glossopharyngeal insuffl ation and breath-hold diving induced pulmonary edema deserves further study ( 8 ).…”

Section: Discussionmentioning

confidence: 99%