injuries poisoning
Immersion Pulmonary Edema
Introduction
Immersion pulmonary edema is sudden-onset pulmonary edema that typically occurs at the surface or early during a dive while at depth. (See also Overview of Diving Injuries .) Immersion pulmonary edema has become more widely recognized over the past 2 decades. Immersion pulmonary edema is not related to Pulmonary Barotrauma or Severe dyspnea develops, usually while the diver is at depth. Divers usually ascend rapidly and have cough, frothy sputum, scattered crackles throughout both lung fields, and sometimes cyanosis. Oxygen Desaturation is often present and may result in death. Chest x-ray shows typical pulmonary edema. Cardiac evaluation usually shows normal right and left ventricular function and normal coronary arteries, but wall motion abnormalities, valvular dysfunction, and cardiomyopathies (including Takotsubo cardiomyopathy) have been reported as causes. Diastolic dysfunction can be documented by echocardiography. Oxygen administration to treat hypoxemia, and sometimes inhaled beta-2 agonists are usually sufficient to allow immersion pulmonary edema to resolve. Diuretics are rarely required. Mechanical ventilation may be necessary for severe cases. Recompression Therapy is not indicated. 