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

Abstract Background Immersion Pulmonary Edema (IPE) is a common and potentially serious diving accident that can have significant respiratory and cardiac consequences and, in some cases, be fatal. Our objective was to characterize cases of IPE among military trainees and recreational divers and to a...

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Main Authors: Dorian Wolff, Olivier Castagna, Jean Morin, Henri Lehot, Romain Roffi, Arnaud Druelle, Jean-Éric Blatteau
Format: Article
Language:English
Published: SpringerOpen 2023-11-01
Series:Sports Medicine - Open
Subjects:
Online Access:https://doi.org/10.1186/s40798-023-00659-4
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author Dorian Wolff
Olivier Castagna
Jean Morin
Henri Lehot
Romain Roffi
Arnaud Druelle
Jean-Éric Blatteau
author_facet Dorian Wolff
Olivier Castagna
Jean Morin
Henri Lehot
Romain Roffi
Arnaud Druelle
Jean-Éric Blatteau
author_sort Dorian Wolff
collection DOAJ
description Abstract Background Immersion Pulmonary Edema (IPE) is a common and potentially serious diving accident that can have significant respiratory and cardiac consequences and, in some cases, be fatal. Our objective was to characterize cases of IPE among military trainees and recreational divers and to associate their occurrence with exposure and individual background factors such as age and comorbidity. We conducted a retrospective analysis on the medical records and diving parameters of all patients who were treated for IPE at the Hyperbaric Medicine Department of Sainte-Anne Military Hospital in Toulon, France, between January 2017 and August 2019. In total, 57 subjects were included in this study, with ages ranging from 20 to 62 years. These subjects were divided into two distinct groups based on exposure categories: (1) underwater/surface military training and (2) recreational scuba diving. The first group consisted of 14 individuals (25%) with a mean age of 26.5 ± 2.6 years; while, the second group comprised 43 individuals (75%) with a mean age of 51.2 ± 7.5 years. All divers under the age of 40 were military divers. Results In 40% of cases, IPE occurred following intense physical exercise. However, this association was observed in only 26% of recreational divers, compared to 86% of military divers. Among civilian recreational divers, no cases of IPE were observed in subjects under the age of 40. The intensity of symptoms was similar between the two groups, but the duration of hospitalization was significantly longer for the recreational subjects. Conclusion It seems that the occurrence of IPE in young and healthy individuals requires their engagement in vigorous physical activity. Additionally, exposure to significant ventilatory constraints is a contributing factor, with the intensity of these conditions seemingly exclusive to military diving environments. In contrast, among civilian recreational divers, IPE tends to occur in subjects with an average age twice that of military divers. Moreover, these individuals exhibit more prominent comorbidity factors, and the average level of environmental stressors is comparatively lower.
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spelling doaj.art-660abc4e43b041288959264a374042172023-11-20T09:32:26ZengSpringerOpenSports Medicine - Open2198-97612023-11-019111010.1186/s40798-023-00659-4Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational DiversDorian Wolff0Olivier Castagna1Jean Morin2Henri Lehot3Romain Roffi4Arnaud Druelle5Jean-Éric Blatteau6SAMU 95, Hôpital NOVOUnderwater research team–ERRSO, Military Biomedical Research Institute-IRBADiving Medicine Consultation Services and Hyperbaric Chamber, Ste Anne Military Hospital (HIA Ste Anne)Diving Medicine Consultation Services and Hyperbaric Chamber, Ste Anne Military Hospital (HIA Ste Anne)Diving Medicine Consultation Services and Hyperbaric Chamber, Ste Anne Military Hospital (HIA Ste Anne)France French Navy Diving SchoolDiving Medicine Consultation Services and Hyperbaric Chamber, Ste Anne Military Hospital (HIA Ste Anne)Abstract Background Immersion Pulmonary Edema (IPE) is a common and potentially serious diving accident that can have significant respiratory and cardiac consequences and, in some cases, be fatal. Our objective was to characterize cases of IPE among military trainees and recreational divers and to associate their occurrence with exposure and individual background factors such as age and comorbidity. We conducted a retrospective analysis on the medical records and diving parameters of all patients who were treated for IPE at the Hyperbaric Medicine Department of Sainte-Anne Military Hospital in Toulon, France, between January 2017 and August 2019. In total, 57 subjects were included in this study, with ages ranging from 20 to 62 years. These subjects were divided into two distinct groups based on exposure categories: (1) underwater/surface military training and (2) recreational scuba diving. The first group consisted of 14 individuals (25%) with a mean age of 26.5 ± 2.6 years; while, the second group comprised 43 individuals (75%) with a mean age of 51.2 ± 7.5 years. All divers under the age of 40 were military divers. Results In 40% of cases, IPE occurred following intense physical exercise. However, this association was observed in only 26% of recreational divers, compared to 86% of military divers. Among civilian recreational divers, no cases of IPE were observed in subjects under the age of 40. The intensity of symptoms was similar between the two groups, but the duration of hospitalization was significantly longer for the recreational subjects. Conclusion It seems that the occurrence of IPE in young and healthy individuals requires their engagement in vigorous physical activity. Additionally, exposure to significant ventilatory constraints is a contributing factor, with the intensity of these conditions seemingly exclusive to military diving environments. In contrast, among civilian recreational divers, IPE tends to occur in subjects with an average age twice that of military divers. Moreover, these individuals exhibit more prominent comorbidity factors, and the average level of environmental stressors is comparatively lower.https://doi.org/10.1186/s40798-023-00659-4Immersion pulmonary edemaAgePhysical exerciseRecreational diveMilitary dive
spellingShingle Dorian Wolff
Olivier Castagna
Jean Morin
Henri Lehot
Romain Roffi
Arnaud Druelle
Jean-Éric Blatteau
Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers
Sports Medicine - Open
Immersion pulmonary edema
Age
Physical exercise
Recreational dive
Military dive
title Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers
title_full Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers
title_fullStr Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers
title_full_unstemmed Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers
title_short Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers
title_sort characterizing immersion pulmonary edema ipe a comparative study of military and recreational divers
topic Immersion pulmonary edema
Age
Physical exercise
Recreational dive
Military dive
url https://doi.org/10.1186/s40798-023-00659-4
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