Immersion pulmonary edema

[Tariq Zaki]

Immersion pulmonary edema is sudden development of fluid in the lungs that typically occurs early during a dive and at depth.
(See also Overview of Diving Injuries.)
Immersion pulmonary edema has become more common over the past two decades. It usually occurs in competitive open-water swimmers but can also occur in divers. A likely cause of the disorder is excessive elevation of the pressure in blood vessels within the lung, causing leakage of plasma into the air spaces. Immersion pulmonary edema is not related to lung barotrauma or decompression sickness. Cold water and a history of high blood pressure 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 are sometimes necessary. Recompression therapy is not given.