The breathless swimmer: could this be swimming-induced pulmonary edema?

Hull, James H.; Wilson, Mathew G

doi:10.1186/s40798-018-0166-8

Cited by 5 publications

(3 citation statements)

References 18 publications

(17 reference statements)

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“…There are also some clinical presentations and scenarios that are unique and specific to sport, for example, swimming-induced pulmonary oedema (SIPE) 6. Thus, while the broad principles of clinical assessment of the respiratory system apply, there are several caveats and considerations when assessing the athletic population.…”

Section: Introductionmentioning

confidence: 99%

BTS clinical statement for the assessment and management of respiratory problems in athletic individuals

Hull

Burns

Carre

et al. 2022

Thorax

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Section: Introductionmentioning

confidence: 99%

BTS clinical statement for the assessment and management of respiratory problems in athletic individuals

Hull

Burns

Carre

et al. 2022

Thorax

Self Cite

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“…Surprisingly, in this study, there was not a reduction in DL CO after swimming training at 1850 m. Most of the swimmers presented a certain breathing discomfort induced by swimming training and/or chlorine after the last training of the altitude training camp. A breathless athlete is challenging due to a non-specific nature of symptoms [48], such as cough and wheeze and poor predictive clinical signs, and we must be cautious before relating SIPO to the athlete's self-report of cough and breathlessness development. SIPO occurs when fluid accumulates in the lungs in the absence of water aspiration during swimming, causing acute shortness of breath and a cough productive of blood-tinged sputum [18].…”

Section: Discussionmentioning

confidence: 99%

Lung Diffusion in a 14-Day Swimming Altitude Training Camp at 1850 Meters

García

Drobnic

Galera

et al. 2020

IJERPH

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Swimming exercise at sea level causes a transient decrease in lung diffusing capacity for carbon monoxide (DLCO). The exposure to hypobaric hypoxia can affect lung gas exchange, and hypoxic pulmonary vasoconstriction may elicit pulmonary oedema. The purpose of this study is to evaluate whether there are changes in DLCO during a 14-day altitude training camp (1850 m) in elite swimmers and the acute effects of a combined training session of swimming in moderate hypoxia and 44-min cycling in acute normobaric severe hypoxia (3000 m). Participants were eight international level swimmers (5 females and 3 males; 17–24 years old; 173.5 ± 5.5 cm; 64.4 ± 5.3 kg) with a training volume of 80 km per week. The single-breath method was used to measure the changes in DLCO and functional gas exchange parameters. No changes in DLCO after a 14-day altitude training camp at 1850 m were detected but a decrease in alveolar volume (VA; 7.13 ± 1.61 vs. 6.50 ± 1.59 L; p = 0.005; d = 0.396) and an increase in the transfer coefficient of the lung for carbon monoxide (KCO; 6.23 ± 1.03 vs. 6.83 ± 1.31 mL·min−1·mmHg−1·L−1; p = 0.038; d = 0.509) after the altitude camp were observed. During the acute hypoxia combined session, there were no changes in DLCO after swimming training at 1850 m, but there was a decrease in DLCO after cycling at a simulated altitude of 3000 m (40.6 ± 10.8 vs. 36.8 ± 11.2 mL·min−1·mmHg−1; p = 0.044; d = 0.341). A training camp at moderate altitude did not alter pulmonary diffusing capacity in elite swimmers, although a cycling session at a higher simulated altitude caused a certain degree of impairment of the alveolar–capillary gas exchange.

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“…Symptoms of SIPE usually resolve after normalization of the physiologic environment and by supportive treatment, such as oxygen therapy and occasionally β2-agonists [18]. Furthermore, the athlete should be aware of the increased possibility of recurrent episodes [19].…”

Section: Discussionmentioning

confidence: 99%

Late-Presenting Swimming-Induced Pulmonary Edema: A Case Report Series from the Norseman Xtreme Triathlon

Melau

Bonnevie-Svendsen

Mathiassen

et al. 2019

Sports

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Swimming-induced pulmonary edema (SIPE) may develop during strenuous physical exertion in water. This case series reports on three cases of suspected late-presenting SIPE during the Norseman Xtreme Triathlon. A 30-year-old male professional (PRO) triathlete, a 40-year-old female AGE GROUP triathlete and a 34-year-old male AGE GROUP triathlete presented with shortness of breath, chest tightness and coughing up pink sputum during the last part of the bike phase. All three athletes reported an improvement in breathing during the first major uphill of the bike phase and increasing symptoms during the downhill. The PRO athlete had a thoracic computed tomography, and the scan showed bilateral ground glass opacity in the peripheral lungs. The male AGE GROUP athlete had a normal chest x-ray. Both athletes were admitted for further observation and discharged from hospital the following day, with complete regression of symptoms. The female athlete recovered quickly following pre-hospital oxygen treatment. Non-cardiogenic pulmonary edema associated with endurance sports is rare but potentially very dangerous. Knowledge and awareness of possible risk factors and symptoms are essential, and the results presented in this report emphasize the importance of being aware of the possible delayed development of symptoms. To determine the presence of pulmonary edema elicited by strenuous exercise, equipment for measuring oxygen saturation should be available for the medical staff on site.

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The breathless swimmer: could this be swimming-induced pulmonary edema?

Cited by 5 publications

References 18 publications

BTS clinical statement for the assessment and management of respiratory problems in athletic individuals

BTS clinical statement for the assessment and management of respiratory problems in athletic individuals

Lung Diffusion in a 14-Day Swimming Altitude Training Camp at 1850 Meters

Late-Presenting Swimming-Induced Pulmonary Edema: A Case Report Series from the Norseman Xtreme Triathlon

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