Severe immersion pulmonary edema in a novice elderly scuba diver after heavy alcohol intake

• Published in: Acute medicine & surgery Vol. 8; no. 1; pp. e703 - n/a
• Main Authors: Morimatsu, Yoshitaka, Nasu, Michitaka, Murata, Yukio, Kitahara, Yusuke, Arakaki, Junya, Fukumoto, Taizo, Nishikiori, Hideharu, Ishitake, Tatsuya
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2021; John Wiley and Sons Inc; Wiley
• Subjects: Alcohol; Alcohol use; Blood; cardiopulmonary arrest; Cardiopulmonary resuscitation; Case Report; CPR; Edema; Ejection fraction; Glasgow Coma Scale; Hospitalization; Hypertension; immersion pulmonary edema; Patients; Pneumonia; Radiography; scuba diving; Swimming; Tomography; United States > US; Alcohol; scuba diving; cardiopulmonary arrest; immersion pulmonary edema; hypertension
• ISSN: 2052-8817; 2052-8817
• DOI: 10.1002/ams2.703

Background There are no reports of immersion pulmonary edema induced by excessive alcohol intake. We describe the case of a novice scuba diver who developed apnea due to immersion pulmonary edema during scuba diving after heavy alcohol intake. Case Presentation A 71‐year‐old hypertensive man, without regular antihypertensive therapy, performed diving after excessive alcohol intake (total amount, approximately 253 g) until the night before. When swimming at a depth of 12 m, the patient experienced chest discomfort and ascended immediately but became unconscious. Respiratory arrest was confirmed, and he spat pink foamy sputum. On hospital admission, hypoxemia was confirmed, and chest radiography revealed butterfly‐shaped shadows. Therefore, mechanical ventilation was initiated. The next day, his blood oxygenation level improved, and the radiographic shadows disappeared. He was discharged on day 7 of hospitalization without sequelae. Conclusion A scuba diver with untreated hypertension might develop immersion pulmonary edema during diving after heavy alcohol intake. We present the case of a novice scuba diver who developed apnea due to immersion pulmonary edema (IPE) during diving after heavy alcohol intake. It is believed that IPE developed when the patient was exposed to a high‐pressure environment with strongly edematous lungs due to heavy drinking.