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Updated: Feb 6, 2026

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol
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Swimming-induced pulmonary edema: current perspectives.

Ralph Smith1, Julian O M Ormerod2, Nikant Sabharwal2

  • 1Department of Sport and Exercise Medicine, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK, ralph.Smith@doctors.org.uk.

Open Access Journal of Sports Medicine
|August 14, 2018
PubMed
Summary

Swimming-induced pulmonary edema (SIPE) is a serious condition causing breathlessness in athletes after water immersion. Awareness and prompt recognition are crucial for management and preventing recurrence in water sports.

Keywords:
breathing difficultiesdivingimmersionopen water swimmingtriathletes

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Area of Science:

  • Sports Medicine
  • Cardiopulmonary Physiology
  • Environmental Medicine

Background:

  • Swimming-induced pulmonary edema (SIPE) is increasingly recognized in water sports participants.
  • It presents as acute breathlessness due to pulmonary edema following water immersion.
  • SIPE can range from mild symptoms to severe respiratory distress and hypoxia.

Purpose of the Study:

  • To provide a current perspective on swimming-induced pulmonary edema (SIPE).
  • To review the incidence, pathophysiology, clinical presentation, and management of SIPE.
  • To offer guidance on return to sport and recurrence risk for athletes.

Main Methods:

  • Literature review of swimming-induced pulmonary edema (SIPE).
  • Analysis of recent advances in understanding SIPE pathophysiology.
  • Synthesis of clinical presentation, management, and recurrence data.

Main Results:

  • SIPE is characterized by pulmonary edema and exaggerated pulmonary vascular pressures.
  • Symptoms typically resolve within 48 hours of leaving the water.
  • Predisposing factors are being identified through ongoing research.

Conclusions:

  • Awareness of SIPE among athletes and event organizers is essential.
  • Prompt recognition aids in preventing drowning and guides medical management.
  • Understanding SIPE is critical for advising athletes on safe return to water sports.