Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers

Area of Science:

• Diving Medicine
• Cardiorespiratory Physiology
• Environmental Health

Background:

• Immersion Pulmonary Edema (IPE) is a potentially fatal diving accident with significant cardiorespiratory consequences.
• Characterizing IPE cases in military trainees and recreational divers is crucial for understanding risk factors.
• Previous studies highlight the need to associate IPE occurrence with exposure and individual background factors like age and comorbidity.

Purpose of the Study:

• To characterize Immersion Pulmonary Edema (IPE) cases in military trainees and recreational divers.
• To associate IPE occurrence with specific exposure and individual background factors.
• To compare IPE characteristics between military and recreational diving populations.

Main Methods:

• Retrospective analysis of medical records and diving parameters for 57 IPE patients treated between January 2017 and August 2019.
• Categorization of patients into two groups: military training (n=14) and recreational scuba diving (n=43).
• Comparison of age, exposure, and comorbidity factors between the two groups.

Main Results:

• IPE occurred after intense physical exercise in 40% of cases, significantly higher in military divers (86%) than recreational divers (26%).
• No IPE cases were observed in recreational divers under 40; military divers in the study were all under 40.
• While symptom intensity was similar, hospitalization duration was longer for recreational divers.

Conclusions:

• Vigorous physical activity is key for IPE in young, healthy individuals, often seen in military diving due to ventilatory constraints.
• Recreational divers with IPE are older, have more comorbidities, and experience lower environmental stressors compared to military divers.
• IPE risk factors differ significantly between military and recreational diving contexts, necessitating tailored prevention strategies.