Pulmonary edema after competitive breath-hold diving

• Published in: Journal of applied physiology (1985) Vol. 104; no. 4; pp. 986 - 990
• Main Authors: Liner, Mats H, Andersson, Johan P. A
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Am Physiological Soc 01.04.2008; American Physiological Society
• Subjects: Adolescent; Adult; Apnea; Athletic Performance - physiology; Basic Medicine; Biological and medical sciences; Blood-Air Barrier - physiology; Competition; Diving; Diving - adverse effects; Diving - physiology; dynamic spirometry; Female; Forced Expiratory Volume - physiology; Fundamental and applied biological sciences. Psychology; Fysiologi; hemoptysis; Hemoptysis - physiopathology; Humans; hypoxemia; Hypoxia - physiopathology; Lung - physiology; Lung - physiopathology; Male; Medical and Health Sciences; Medicin och hälsovetenskap; Medicinska och farmaceutiska grundvetenskaper; Oxygen; Oxygen - blood; Physiology; Pulmonary Edema - etiology; pulse oximetry; Respiratory Function Tests; Respiratory Mechanics - physiology; Respiratory system; Risk factors; Spirometry; Studies; Veins & arteries; Vital Capacity - physiology; Competition; pulse oximetry; Spirometry; Oxygen; Respiratory disease; Lung edema; Hemorrhage; dynamic spirometry; Vertebrata; Hemoptysis; Apnea; Hypoxemia; Mammalia; Diving
• ISSN: 8750-7587; 1522-1601; 1522-1601
• DOI: 10.1152/japplphysiol.00641.2007

1 Department of Clinical Sciences, Section of Anesthesiology and Intensive Care, and 2 Department of Cell and Organism Biology, Lund University, Lund, Sweden Submitted 15 June 2007 ; accepted in final form 21 January 2008 During an international breath-hold diving competition, 19 of the participating divers volunteered for the present study, aimed at elucidating possible symptoms and signs of pulmonary edema after deep dives. Measurements included dynamic spirometry and pulse oximetry, and chest auscultation was performed on those with the most severe symptoms. After deep dives (25–75 m), 12 of the divers had signs of pulmonary edema. None had any symptoms or signs after shallow pool dives. For the whole group of 19 divers, average reductions in forced vital capacity (FVC) and forced expiratory volume in the first second (FEV 1 ) were –9 and –12%, respectively, after deep dives compared with after pool dives. In addition, the average reduction in arterial oxygen saturation (Sa O 2 ) was –4% after the deep dives. In six divers, respiratory symptoms (including dyspnea, cough, fatigue, substernal chest pain or discomfort, and hemoptysis) were associated with aggravated deteriorations in the physiological variables (FVC: –16%; FEV 1 : –27%; Sa O 2 : –11%). This is the first study showing reduced spirometric performance and arterial hypoxemia as consequences of deep breath-hold diving, and we suggest that the observed changes are caused by diving-induced pulmonary edema. From the results of the present study, it must be concluded that the great depths reached by these elite apnea divers are associated with a risk of pulmonary edema. apnea; hemoptysis; hypoxemia; dynamic spirometry; pulse oximetry Address for reprint requests and other correspondence: M. H. Linér, Heart and Lung Center, EB15, Lund Univ. Hospital, SE-221 85 Lund, Sweden (e-mail: Mats.Liner{at}med.lu.se )