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(Chest. 2001;120:1686-1694.)
© 2001 American College of Chest Physicians

Pulmonary Edema Associated With Scuba Diving*

Case Reports and Review

John B. Slade, Jr, MD; Takashi Hattori, MD; Carolyn S. Ray, MD; Alfred A. Bove, MD, PhD and Paul Cianci, MD

* From Doctors Medical Center (Drs. Slade, Ray, and Cianci), San Pablo, CA; Community Hospital of the Monterey Peninsula (Dr. Hattori), Monterey, CA; and Temple University Medical Center (Dr. Bove), Philadelphia, PA.

Correspondence to: John B. Slade, Jr, MD, Doctors Medical Center, San Pablo, San Pablo, CA 94806; e-mail: jslade1515{at}aol.com

Acute pulmonary edema has been associated with cold-water immersion in swimmers and divers. We report on eight divers using a self-contained underwater breathing apparatus (scuba) who developed acute pulmonary edema manifested by dyspnea, hypoxemia, and characteristic chest radiographic findings. All cases occurred in cold water. All scuba divers were treated with complete resolution, and three have returned to diving without further episodes. Mechanisms that would contribute to a raised capillary transmural pressure or to a reduced blood-gas barrier function or integrity are discussed. Pulmonary edema in scuba divers is multifactorial, and constitutional factors may play a role. Physicians should be aware of this potential, likely underreported, problem in scuba divers.

Key Words: altitude sickness • diving • hypoxia • immersion • pulmonary edema • respiratory distress syndrome • swimming




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