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Immersion pulmonary edema: case reports from Oceania.
Carl Edmonds1, John Lippmann2,3, Andrew Fock3,4
1MRCP, retired.
Summary
This study documented 31 immersion pulmonary edema (IPE) cases in Oceania divers, finding cardiac anomalies like valvular disease and cardiomyopathies were frequent contributing factors. Nine fatalities occurred, highlighting the serious risks associated with IPE in diving environments.
Area of Science:
- Cardiovascular Physiology
- Diving Medicine
- Pulmonary Edema Research
Background:
- Investigated immersion pulmonary edema (IPE) in divers from Oceania between 2002 and 2018.
- Utilized DAN AP Fatality Database, case reports, and survivor interviews for case identification.
Observation:
- Documented 31 IPE incidents involving scuba divers, nitrox divers, and surface snorkelers.
- Average victim age was 53 years, with 58% females; average dive profile: 19m depth for 25 minutes.
- Nine fatalities (29%) were recorded, with six victims (19%) having prior IPE episodes.
Findings:
- Cardiac anomalies were primary associated factors, including valvular disease (29%), transient cardiomyopathies (26%), and dysrhythmias (16%).
- Identified common IPE associations: exertion, stress, cold, negative inspiratory pressure, and hypertension.
- Chronic cardiac disorders (valvular, coronary artery disease) and transient conditions (dysrhythmias, stress cardiomyopathy) were frequently observed.
Implications:
- Highlights the significant role of underlying cardiac conditions in IPE development among divers.
- Suggests that both chronic and transient cardiac issues may contribute to or result from IPE.
- Underscores the need for cardiac screening and awareness in diving populations to mitigate IPE risks.
