Linér Mats H, Andersson Johan P A
Heart and Lung Center, EB15, Lund Univ. Hospital, SE-221 85 Lund, Sweden.
J Appl Physiol (1985). 2008 Apr;104(4):986-90. doi: 10.1152/japplphysiol.00641.2007. Epub 2008 Jan 24.
During an international breath-hold diving competition, 19 of the participating divers volunteered for the present study, aimed at elucidating possible symptoms and signs of pulmonary edema after deep dives. Measurements included dynamic spirometry and pulse oximetry, and chest auscultation was performed on those with the most severe symptoms. After deep dives (25-75 m), 12 of the divers had signs of pulmonary edema. None had any symptoms or signs after shallow pool dives. For the whole group of 19 divers, average reductions in forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)) were -9 and -12%, respectively, after deep dives compared with after pool dives. In addition, the average reduction in arterial oxygen saturation (Sa(O(2))) was -4% after the deep dives. In six divers, respiratory symptoms (including dyspnea, cough, fatigue, substernal chest pain or discomfort, and hemoptysis) were associated with aggravated deteriorations in the physiological variables (FVC: -16%; FEV(1): -27%; Sa(O(2)): -11%). This is the first study showing reduced spirometric performance and arterial hypoxemia as consequences of deep breath-hold diving, and we suggest that the observed changes are caused by diving-induced pulmonary edema. From the results of the present study, it must be concluded that the great depths reached by these elite apnea divers are associated with a risk of pulmonary edema.
在一次国际屏气潜水比赛期间，19名参赛潜水员自愿参与了本研究，旨在阐明深度潜水后肺水肿可能出现的症状和体征。测量项目包括动态肺量计检查和脉搏血氧饱和度测定，对症状最严重的潜水员进行了胸部听诊。深度潜水（25 - 75米）后，12名潜水员出现了肺水肿体征。浅水池潜水后无人出现任何症状或体征。对于19名潜水员的整个群体，与水池潜水后相比，深度潜水后用力肺活量（FVC）和第一秒用力呼气量（FEV₁）的平均降低幅度分别为9%和12%。此外，深度潜水后动脉血氧饱和度（SaO₂）的平均降低幅度为4%。在6名潜水员中，呼吸系统症状（包括呼吸困难、咳嗽、疲劳、胸骨后胸痛或不适以及咯血）与生理变量的加重恶化相关（FVC：-16%；FEV₁：-27%；SaO₂：-11%）。这是第一项表明深度屏气潜水会导致肺量计检查表现下降和动脉血氧不足的研究，我们认为观察到的这些变化是由潜水诱发的肺水肿引起的。根据本研究结果，必须得出结论，这些精英自由潜水员所达到的极深深度与肺水肿风险相关。
