Immersion pulmonary edema: drowning from the inside: editorial commentary

Abstract

Immersion pulmonary (IPE, also known as swimming-induced pulmonary edema, SIPE) is a condition in which pulmonary edema develops rapidly during a dive or vigorous swim. Symptoms include dyspnea and hemoptysis. Physical exam reveals typical signs of bilateral pulmonary edema, which can be confirmed radiographically or with bedside ultrasound [1-3]. IPE tends to recur in susceptible individuals. Often there are cardiac or pulmonary comorbidities, but IPE can occur in highly fit individuals such as triathletes and military trainees: IPE has been reported among special forces units from both the United States and Israel. Why pulmonary edema, a condition typically associated with heart failure, should occur in normal individuals remains somewhat of a mystery.