University Hospitals Dept of Physiology, EA3920 University of Bourgogne Franche Comté, Besançon, France.
Corresponding author: Dr Jacques Regnard, University Hospitals Dept of Physiology, EA3920 University of Bourgogne Franche Comté, Besançon, 25000, France,
Diving Hyperb Med. 2021 Dec 20;51(4):376-381. doi: 10.28920/dhm51.4.376-381.
Symptoms and contributing factors of immersion pulmonary oedema (IPO) are not observed during non-immersed heart and lung function assessments. We report a case in which intense snorkelling led to IPO, which was subsequently investigated by duplicating cardiopulmonary exercise testing with (neoprene vest test - NVT) and without (standard test - ST) the wearing of a neoprene vest. The two trials utilised the same incremental cycling exercise protocol. The vest hastened the occurrence and intensity of dyspnoea and leg fatigue (Borg scales) and led to an earlier interruption of effort. Minute ventilation and breathing frequency rose faster in the NVT, while systolic blood pressure and pulse pressure were lower than in the ST. These observations suggest that restrictive loading of inspiratory work caused a faster rise of intensity and unpleasant sensations while possibly promoting pulmonary congestion, heart filling impairment and lowering blood flow to the exercising muscles. The subject reported sensations close to those of the immersed event in the NVT. These observations may indicate that increased external inspiratory loading imposed by a tight vest during immersion could contribute to pathophysiological events.
在非浸没心肺功能评估期间，不会观察到浸没性肺水肿（IPO）的症状和促成因素。我们报告了一个案例，其中剧烈的浮潜导致了 IPO，随后通过重复心肺运动测试（氯丁橡胶背心测试-NVT）和不穿氯丁橡胶背心（标准测试-ST）来对此进行研究。这两个试验都使用了相同的递增式自行车运动方案。背心加速了呼吸困难和腿部疲劳（Borg 量表）的发生和强度，并导致更早地中断努力。在 NVT 中，分钟通气量和呼吸频率上升得更快，而收缩压和脉压则低于 ST。这些观察结果表明，吸气工作的限制负荷导致强度和不愉快感觉更快地上升，同时可能促进肺水肿、心脏充盈受损和运动肌肉的血流量降低。受试者在 NVT 中报告了接近沉浸事件的感觉。这些观察结果可能表明，在浸没期间由紧身背心施加的增加的外部吸气负荷可能导致病理生理事件。
