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Immersion Pulmonary Edema

by Alfred A. Bove, MD, PhD

Immersion pulmonary edema is sudden development of fluid in the lungs that typically occurs early during a dive and at depth.

Immersion pulmonary edema has become more common over the past two decades. A likely cause is changes in pressure in the chest cavity that make it difficult to expand the lungs. As a result, the person needs to suck in forcefully in order to breathe. Immersion pulmonary edema is not related to lung barotrauma or decompression sickness. Cold water and a history of high blood pressure are risk factors.

Divers usually ascend rapidly and become very short of breath. A cough with frothy sputum is typical. Doctors may do tests such as chest x-rays and echocardiography to confirm the diagnosis. Treatment includes diuretics, such as intravenous furosemide, and oxygen, usually given under pressure by a mask. Mechanical ventilation may be necessary. Recompression therapy is not given.

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