Article: Diving and Immersion Pulmonary Edema

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Negative pressure pulmonary edema has been documented in post-surgical patients. It typically happens in young, athletic males who are extubated (have breathing tubes removed) after surgery and experience subsequent upper airway edema.

Small correction if you don't mind: NPPE occurs not because of upper airway edema but because the vocal cords go into spasm. Once they are in spasm, the breathing effort creates the negative pressure. This usually happens when the tube is take out prematurely (not deep anesthesia). Also it seems to occur in people who are muscular which is mentioned correctly as athletes.

Sorry to point this out but I want to be sure to put out the correct clinical scenario.
 
Small correction if you don't mind: NPPE occurs not because of upper airway edema but because the vocal cords go into spasm. Once they are in spasm, the breathing effort creates the negative pressure. This usually happens when the tube is take out prematurely (not deep anesthesia). Also it seems to occur in people who are muscular which is mentioned correctly as athletes.

Sorry to point this out but I want to be sure to put out the correct clinical scenario.

No apology necessary. I was going by literature that I'd read at the time I wrote the post. Thanks for adding this.

Best regards,
DDM
 
@Duke Dive Medicine

The BSAC changed its diver training materials a few years ago to include IPE. Dr Peter Wilmhurst is probably the contact in the UK to talk to regarding material, research etc, used by him and the BSAC.


Guidance Released by BSAC on Immersion Pulmonary Oedema for Scuba Divers and Instructors

The lungs and Immersion Pulmonary Oedema (IPO) | Anatomy of a diver

The hidden killer: Immersion pulmonary oedema (IPO)

A lot of the BSAC material is behind the members firewall.

Gareth
 
@Duke Dive Medicine

The BSAC changed its diver training materials a few years ago to include IPE. Dr Peter Wilmhurst is probably the contact in the UK to talk to regarding material, research etc, used by him and the BSAC.


Guidance Released by BSAC on Immersion Pulmonary Oedema for Scuba Divers and Instructors

The lungs and Immersion Pulmonary Oedema (IPO) | Anatomy of a diver

The hidden killer: Immersion pulmonary oedema (IPO)

A lot of the BSAC material is behind the members firewall.

Gareth

Thanks Gareth. There has been a lot more attention on IPE since this thread was started in 2012. I'm glad to see that it's making its way into the mainstream of diving education.

Best regards,
DDM
 
excellent information !, thank you very much for sharing ....
 
Here is a nice article on NPPE. Appreciate @Duke Dive Medicine commentary. Perhaps I did not word it correctly about upper airway edema. While edema may be present, the very common cause of NPPE is immediately after removal of breathing tube from an anesthetized patient. Airway edema must be sufficiently large to obstruct the airway and cause NPPE. This can occur as say allergic reactions to medications or other mechanical issue where air cannot enter the lungs (say a person vomits and cannot clear their airway).

I don't mean to distract the main topic of this thread which I find very interesting.

Please stay healthy during this pandemic.
 
Blast from the past. I actually wrote the article in 2011, and it didn't get published until late 2012.

It was casually reviewed by several medical professionals in the field at the time. Hopefully it's still accurate all these years later. :)
 
https://www.shearwater.com/products/peregrine/

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