(See also Overview of Diving Injuries Overview of Diving Injuries People who engage in deep-sea or scuba diving are at risk of a number of injuries, most of which are caused by changes in pressure. These disorders also can affect people who work in underwater... read more .)
Immersion pulmonary edema has become more widely recognized over the past two decades. It happens when blood from the legs and abdomen is redistributed to the lungs, which increases pressure in the blood vessels of the lungs, causing leakage of plasma into the air spaces. This usually occurs in competitive open-water swimmers at the surface but can also occur in divers. Immersion pulmonary edema is not related to lung barotrauma Pulmonary (lung) barotrauma Barotrauma is tissue injury caused by a change in pressure, which compresses or expands gas contained in various body structures. The lungs, gastrointestinal tract, part of the face covered... read more or decompression sickness Decompression Sickness Decompression sickness is a disorder in which nitrogen dissolved in the blood and tissues by high pressure forms bubbles as pressure decreases. Symptoms can include fatigue and pain in muscles... read more . Cold water and a history of high blood pressure High Blood Pressure High blood pressure (hypertension) is persistently high pressure in the arteries. Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying... read more and other cardiovascular disorders are risk factors.
Divers usually ascend rapidly and become very short of breath. A cough with frothy or bloody 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 removal from the water and oxygen. Diuretics and mechanical ventilation Mechanical Ventilation Mechanical ventilation is use of a machine to aid the movement of air into and out of the lungs. Some people with respiratory failure need a mechanical ventilator (a machine that helps air get... read more in the hospital are sometimes necessary. Recompression therapy is not given.
Doctors will screen people who have had immersion pulmonary edema for
Doctors will also consider silent coronary artery disease in people with appropriate risk factors.
Immersion pulmonary edema tends to recur in susceptible individuals; therefore, such people should be evaluated for treatable risk factors before returning to diving or competitive swimming.
The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
Divers Alert Network: 24-hour emergency hotline, 919-684-9111
Duke Dive Medicine: 24-hour emergency consultation with a doctor, 919-684-8111