ArticleSports medicine - open2018
The Key Roles of Negative Pressure Breathing and Exercise in the Development of Interstitial Pulmonary Edema in Professional Male SCUBA Divers.
Article in Sports medicine - open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Joint position statement on immersion pulmonary oedema and diving from the South Pacific Underwater Medicine Society (SPUMS) and the United Kingdom Diving Medical Committee (UKDMC) 2024.Diving and hyperbaric medicine · 2024Guideline
- Heliox versus trimix in closed-circuit rebreather diving: A comparative study of pulmonary and decompression stress in male divers.Physiological reports · 2026Article
- Technical diving accidents in France: a 15-year retrospective study reporting a high prevalence of musculoskeletal decompression sickness.Diving and hyperbaric medicine · 2026Article
- Diving practices in technical divers' community and behaviour towards self-reported unusual symptoms.Diving and hyperbaric medicine · 2025Article
- Extremely deep bounce dives: planning and physiological challenges based on the experiences of a sample of French-speaking technical divers.Diving and hyperbaric medicine · 2025Article
- Snorkelling and Breath-Hold Diving Fatalities in Australia-A Review of 317 Deaths.International journal of environmental research and public health · 2025Review
- The effect of a single closed-circuit rebreather decompression dive in extremely cold water to cardiac function.European journal of applied physiology · 2024Article
- Characterizing Immersion Pulmonary Edema (IPE): A Comparative Study of Military and Recreational Divers.Sports medicine - open · 2023Article
- Individual Changes in Respiratory Compliance Upon Immersion May Predict Susceptibility to Immersion Pulmonary Edema.Sports medicine - open · 2023Article
- Oxygen uptake (Frontiers in physiology · 2023Article
- A century of exercise physiology: lung fluid balance during and following exercise.European journal of applied physiology · 2023Review
- Pulmonary Effects of One Week of Repeated Recreational Closed-Circuit Rebreather Dives in Cold Water.Medicina (Kaunas, Lithuania) · 2022Article
- Observational
- Global longitudinal strain assessment of cardiac function and extravascular lung water formation after diving using semi-closed circuit rebreather.European journal of applied physiology · 2022Observational
- Symptomatic or asymptomatic SAR-CoV-2 positive divers should be medically evaluated before returning to scuba diving.Frontiers in physiology · 2022Article
- Commentary: The Circulatory Effects of Increased Hydrostatic Pressure Due to Immersion and Submersion.Frontiers in physiology · 2022Article
- A neoprene vest hastens dyspnoea and leg fatigue during exercise testing: entangled breathing and cardiac hindrance?Diving and hyperbaric medicine · 2021Article
- Physiological effects of mixed-gas deep sea dives using a closed-circuit rebreather: a field pilot study.European journal of applied physiology · 2021Article
- Medical conditions that affect the risk of diving.BJA education · 2021Review
- Broad individual immersion-scattering of respiratory compliance likely substantiates dissimilar breathing mechanics.Scientific reports · 2021Article
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmersion pulmonary edema is potentially a catastrophic condition; however, the pathophysiological mechanisms are ill-defined. This study assessed the individual and combined effects of exertion and negative pressure breathing on the cardiovascular system during the development of pulmonary edema in SCUBA divers.
methodsSixteen male professional SCUBA divers performed four SCUBA dives in a freshwater pool at 1 m depth while breathing air at either a positive or negative pressure both at rest or with exercise. Echocardiography and lung ultrasound were used to assess the cardiovascular changes and lung comet score (a measure of interstitial pulmonary edema).
resultsThe ultrasound lung comet score was 0 following both the dives at rest regardless of breathing pressure. Following exercise, the mean comet score rose to 4.2 with positive pressure breathing and increased to 15.1 with negative pressure breathing. The development of interstitial pulmonary edema was significantly related to inferior vena cava diameter, right atrial area, tricuspid annular plane systolic excursion, right ventricular fractional area change, and pulmonary artery pressure. Exercise combined with negative pressure breathing induced the greatest changes in these cardiovascular indices and lung comet score.
conclusionsA diver using negative pressure breathing while exercising is at greatest risk of developing interstitial pulmonary edema. The development of immersion pulmonary edema is closely related to hemodynamic changes in the right but not the left ventricle. Our findings have important implications for divers and understanding the mechanisms of pulmonary edema in other clinical settings.
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