Immersion Pulmonary Edema
(See also Overview of Diving Injuries.)
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. It usually occurs in competitive open-water swimmers. A likely cause of the disorder 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 and blood oxygen levels are low.
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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