Effects of water immersion on pulmonary function in asthmatics

Immersion induces air trapping in the lungs, as does asthma. Consequently, when using diving apparatus, asthmatics may face greater risk than non-asthmatics of pulmonary barotrauma (PBT) during ascent. We studied the pulmonary airflows and closing capacities (CC = closing volume + residual volume) in subjects with exercise-induced asthma (A, n = 12) and in healthy controls (C, n = 11) under four conditions: dry and immersed, both before and after exercise (treadmill running, non-immersed). Immersed, both C and A had significant and equivalent reductions in vital capacity, FEV1, FEV1/FVC, and FEF25%-75%. Post-exercise and immersed, pulmonary airflows deteriorated further in A but were better in C: FEV1 (A, 3.6 +/- 0.8 liter vs. 3.3 +/- 0.8 liter, P = 0.001; C, 3.9 +/- 0.5 liter vs. 4.1 +/- 0.6 liter, P = 0.006), FEF25-75% (A, 3.5 +/- 1.0 liter x s(-1) vs. 3.0 +/- 0.8 liter x s(-1). P < 0.05; C, 4.0 +/- 0.9 liter x s(-1) vs. 4.3 +/- 0.9 liter x s(-1), P < 0.05). Therefore, in contrast to C, A subjects had reduced pulmonary airflows during immersion after exercise. Furthermore, A subjects more often had no closing volume phase IV when immersed after exercise than C (P = 0.005). Interpreting the absence of phase IV as indicative of more air trapping in the asthmatics during immersion after exercise would be consistent with the reductions in airflow.