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Thread: Do you know about Immersion Pulmonary Edema? You should...

  1. #11
    Bob Sweeney bobmaggi has a spectacular aura about bobmaggi has a spectacular aura about bobmaggi has a spectacular aura about bobmaggi has a spectacular aura about bobmaggi has a spectacular aura about bobmaggi has a spectacular aura about bobmaggi's Avatar
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    Re: Do you know about Immersion Pulmonary Edema? You should...

    I think I had an incident on a dive this weekend. It was a easy dive with some OC divers on a local lake with a max depth of 82 ft and 42 degrees for 45 minutes. I was fine through most of the dive and didn't notice anything until late in the dive in 40 ft or less depth. It really didn't become a real issue until the surface swim back to the boat ramp. This is about a 500 ft swim and I started wheezing quite a bit on the way back and felt a lot of fluid in the lungs. Once out of the water most of the symptoms disappeared over about an hour.

    This has me a bit worried on how often this might occur. I certainly don't want to do any more deco dives until I get a handle on this. The only thing I did different on hydration was drinking a cola shortly before the dive on top of the normal water. I'll try cutting down on the water intake before the dive next weekend and keep it a short and shallow dive and see how it goes.

  2. #12
    RBW Member dreamdive has disabled reputation dreamdive's Avatar
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    Re: Do you know about Immersion Pulmonary Edema? You should...

    Quote Originally Posted by bobmaggi  View Original Post
    I think I had an incident on a dive this weekend. It was a easy dive with some OC divers on a local lake with a max depth of 82 ft and 42 degrees for 45 minutes. I was fine through most of the dive and didn't notice anything until late in the dive in 40 ft or less depth. It really didn't become a real issue until the surface swim back to the boat ramp. This is about a 500 ft swim and I started wheezing quite a bit on the way back and felt a lot of fluid in the lungs. Once out of the water most of the symptoms disappeared over about an hour.

    This has me a bit worried on how often this might occur. I certainly don't want to do any more deco dives until I get a handle on this. The only thing I did different on hydration was drinking a cola shortly before the dive on top of the normal water. I'll try cutting down on the water intake before the dive next weekend and keep it a short and shallow dive and see how it goes.
    Glad you are fine. You might have had an episode - hard to say. You might want to make sure you don't have an underlying medical problem such has high blood pressure or an unrecognized cardiac condition that may have caused this, too. As far as your water intake: from a very interesting medical study in 2011, it appears that hydration POST-diving is more important. So please, re-hydrate immediately after the dive.

    Wishing you the best and hope you never experience anything like this again.

    Claudia R

  3. #13
    Stevie Tippetts Stevie Tippetts is an unknown quantity at this point Stevie Tippetts's Avatar
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    Re: Do you know about Immersion Pulmonary Edema? You should...

    Quote Originally Posted by dreamdive  View Original Post
    Glad you are fine. You might have had an episode - hard to say. You might want to make sure you don't have an underlying medical problem such has high blood pressure or an unrecognized cardiac condition that may have caused this, too. As far as your water intake: from a very interesting medical study in 2011, it appears that hydration POST-diving is more important. So please, re-hydrate immediately after the dive.

    Wishing you the best and hope you never experience anything like this again.

    Claudia R
    I had to deal with a case of this very recently. Thankfully after Claudia's recent highlighting of the condition, it was at the forefront of my immediate assessment. Casualty made a full recovery but has been counseled on a FULL medical on return home and before any subsequent diving trips.

    Thanks Claudia!

  4. #14
    New Member Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell has a reputation beyond repute Simon Mitchell's Avatar
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    Re: Do you know about Immersion Pulmonary Edema? You should...

    Quote Originally Posted by Semaj  View Original Post
    If you suffer an episode of IPE does this mean you can/ should not dive again?

    We had an OC diver in our club suffer from IPE last year, it was a very scary experience not knowing what was happening to him. He recovered and was advised by our local hyperbaric specialist not to dive again.
    Hello,

    I agree with Claudia's comment that this is a personal risk vs benefit decision. It is vital, however, that divers making such decisions are properly informed. A crucial component to being "informed" is an awareness that there are now reports (including at least one that is published) of recurrences being fatal.

    This has seen a shift in the advice being given by hyperbaric specialists.

    In the 1990s when awareness of this condition was poor, advice was frequently liberal. Divers who had suffered such events were often told that a recurrence may or may not occur, but with some risk mitigation it would be reasonable to make a choice to return to diving. "Risk mitigation" included such strategies as excluding underlying cardiac risk factors, avoiding diving in remote locations or overhead environments, avoiding decompression diving, good thermal protection, diving with well maintained equipment, avoiding negative static lung loads, diving from a platform where oxygen was available etc.

    The recent publication of a case report of a fatal recurrence has made physicians a little more cautious. The paper by Edmonds et al (abstract below) actually reports 3 fatal cases, but only one of these was a recurrence. The recurrence occurred 54 uneventful dives after the first event, illustrating the sporadic and unpredictable nature of this phenomenon.

    With this now in the literature, you can expect more conservative judgements like the one given to your acquaintance, especially in litigious environments like the USA. My own advice has not really changed. I still believe this is a personal risk vs benefit decision, except that I now ensure divers clearly understand that many conservative diving physicians would recommend not diving because of the proven possibility of fatal recurrence. If I was required to actually sign an "approval" for diving eg for the purposes of occupational work or continuing education, I probably would err on the side of conservatism and not do it (every case has subtle nuances so each would be taken on its own merits). This from someone generally considered relatively liberal (some would even say heretic) on diving fitness matters.

    Hope this makes sense,

    Simon M


    Diving Hyperb Med. 2012 Mar;42(1):40-4.
    Scuba divers' pulmonary oedema: recurrences and fatalities.

    Edmonds C, Lippmann J, Lockley S, Wolfers D.
    Source

    puddle@bigpond.com.au

    Abstract

    Scuba divers' pulmonary oedema (SDPE) is an increasingly recognised disorder in divers. We report three fatal cases of SDPE, demonstrating its potential serious nature even in the absence of underlying cardiac disease demonstrable clinically or at autopsy. This, together with the frequency of recurrences, has implications on assessing fitness for subsequent diving, snorkelling and swimming. The differential diagnosis of this disorder is also considered, as is its possible inducement by salt water aspiration and its relationship to drowning.


    PMID:
    22437975
    [PubMed - indexed for MEDLINE]

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