Please Brainstorm

[Cacia]

My friend gets pulmonary edema after freediving. His lungs fill up on some days pretty fast...coarse wet rales audible without a stethoscope. Freediving is know to cause this to varying degrees. Sometimes he gets it at 40 ft, but usually its the depths over 100 feet. He says the blood shunts to the pulmonary bed as a protective mechanism for the lungs at depth. He says other divers less fit are doing some of the same profiles and not having wet lungs. We are racking our heads trying to figure out the variable that is setting him apart.

Ideas, that have entered our minds:

1) compromised alveoli bed permeability, leaks plasma. (possible prior illness, or damage?)

2) low albumin (colloidal hydrostatic pressure effects?) Hasn't had any lab tests.

3) he says hypothermia...long dives...happens faster

4) Trained competitive cyclists, swimmer, runner. Could this in any way be a disadvantage?

It really raised my eyebrows hearing how wet his lungs got, today.
I am concerned the margin before decompensation could be closer than he realizes.

Any sources of information about this? healthy, non-smoker, extremely fit 20/something. Science grad student...he understands physiology, still, its puzzling regarding onset compared to other freedivers.

Feel free to speculate.

 

[Air One]

Pulmonary oedema can happened after free diving : 4 reasons
-the blood volume variations into the lung ( deep freediving) > blood shift
-the blood pressure into the left atrium (if P>30-35 Torr).
-the high pressure on the thorax itself can directly provide oedema ( if the pulmonary volume < 800ml)
-hypoxy can provide lung high bloodpressure.

It's better for him to have a heart check up and a cardiologist advice before to continue to dive that deep ( I'm very surprised that he has oedema at only 40 ft-much less on a 100 ft dive)

I hope it's clear. It's not easy for a French doctor to talk to an american patient !

 

[Ol Dirty Diver]

I presented much more detail about my problem here.

 

[Gene_Hobbs]

Added this paper 2005 today. This has 5 case reports in scuba divers.

Pulmonary edema in scuba divers: recurrence and fatal outcome.
Cochard et. al. 2005
RRR ID: 4032, PMID: 15796313

A search for 'pulmonary edema' yields 385 results. The papers by Hampson in 1997 are worth the time as well.

-- PLEASE note that many are only abstracts and there will not be a paper available for download.

 

[Cacia]

Leland Dao, a friend of mine is the doc for the Triple Crown and lots of the big surf competitions. He has a shingle at the Excell building on the North Shore. He was freediving for awhile...maybe he would be a good start. He diagnosed my AVNRT at dinner, basically. Pretty sharp guy.

He does sports medicine too...Dirty Diver, you could call him.