RT Journal Article
SR Electronic
T1 Swimming-Induced Pulmonary Oedema – A Hazard in Intensive Military Training?
JF Journal of the Royal Army Medical Corps
JO J R Army Med Corps
FD British Medical Journal Publishing Group
SP 258
OP 259
DO 10.1136/jramc-156-04-12
VO 156
IS 4
A1 Tina Knutson
YR 2010
UL http://militaryhealth.bmj.com/content/156/4/258.abstract
AB Swimming-Induced Pulmonary Oedema (SIPE) has been described in military combat swimmers in both the US and Israeli Navies. The pathophysiology is explained by the immersion in cold water, and its effects on central vascular volume. SIPE has been hypothesized to be caused by pulmonary capillary stress failure (PCSF) due to elevations in pulmonary capillary transmural pressure. This leads to mechanical impairment and leakage of blood cells and proteins from capillaries. Patients with SIPE can present with pronounced dyspnoea, cough, hypoxemia and profuse frothy haemoptysis. Physical examination and chest X-rays usually show evidence of pulmonary oedema. The treatment of choice is to recognize the symptoms, get the patient out of the water and follow with close observation for emergent problems. Soldiers prone to acquire SIPE should be identified as this medical condition has a high degree of recurrence. The awareness of the symptoms of SIPE will increase appropriate diagnosis and therefore inform treatment.