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伪装成急性呼吸窘迫综合征的游泳诱发肺水肿:一例报告

Swimming-Induced Pulmonary Edema Masquerading as Acute Respiratory Distress Syndrome: A Case Report.

作者信息

Pokhrel Madalasa, Sharma Nava R, Lamichhane Saral, Bogojevic Marija, Durodola Bolaji, Gillen Adele, Vicioso Mora Yorleny, Kc Prabal, Naaraayan Ashutossh

机构信息

Internal Medicine, Montefiore New Rochelle Hospital, Albert Einstein College of Medicine, New Rochelle, USA.

Internal Medicine, Maimonides Medical Center, Brooklyn, USA.

出版信息

Cureus. 2024 Apr 30;16(4):e59392. doi: 10.7759/cureus.59392. eCollection 2024 Apr.

Abstract

Immersion pulmonary edema, also known as swimming-induced pulmonary edema (SIPE), manifests with cough, dyspnea, hemoptysis, and hypoxemia from flash pulmonary edema after surface swimming, often in healthy young individuals with no predisposing conditions. SIPE commonly resolves spontaneously within 24-48 hours but can be fatal. Post-mortem findings demonstrate heavy, edematous lungs and frothy airways. Although these pathologic findings are like those seen in patients with drowning, SIPE, by definition, is associated with pulmonary edema that develops with a closed glottis without drowning/aspiration. However, patients who develop SIPE during swimming could lose consciousness and drown. Its pathophysiology is poorly understood, and the medical literature infrequently describes SIPE. Due to the multifactorial and complex pathophysiology and the scarcity of medical literature describing SIPE, the diagnosis could be difficult at presentation. This case report elaborates on diagnosing and treating swimming-induced pulmonary edema in a hypertensive and obese female who presented to our emergency room with an acute onset of shortness of breath after recreational swimming in a pool.

摘要

浸没性肺水肿,也称为游泳诱发的肺水肿(SIPE),表现为在水面游泳后突发肺水肿引起的咳嗽、呼吸困难、咯血和低氧血症,常见于无易感因素的健康年轻个体。SIPE通常在24 - 48小时内自行缓解,但也可能致命。尸检结果显示肺部沉重、水肿,气道有泡沫。尽管这些病理表现与溺水患者相似,但根据定义,SIPE与声门关闭时发生的肺水肿相关,而无溺水/误吸情况。然而,游泳时发生SIPE的患者可能会失去意识并溺水。其病理生理学尚不清楚,医学文献中对SIPE的描述也很少。由于其病理生理多因素且复杂,以及描述SIPE的医学文献稀缺,发病时诊断可能困难。本病例报告详细阐述了一名高血压肥胖女性在游泳池进行娱乐性游泳后急性起病出现呼吸急促,就诊于我院急诊室时游泳诱发肺水肿的诊断和治疗情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ece7/11139453/4f9f87b89067/cureus-0016-00000059392-i01.jpg

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