Extravascular Lung Water, Pulmonary Edema - Acute
Conditions
Keywords
pulmonary edema, asymptomatic pulmonary edema, swimming induced pulmonary edema, SIPE, pulmonary edema in swimmers, extravascular lung water
Brief summary
Previous studies suggest that increased extravascular lung water might be found in open water swimmers without respiratory symptoms. This study aims to investigate a large number of asymptomatic individuals after an open-water swimming race to assess the prevalence of increased extravascular lung water in asymptomatic open-water swimmers.
Detailed description
Swimming-induced pulmonary edema (SIPE) can occur during open-water swimming. The pathophysiological mechanisms are still partly unknown, but central pooling of blood volume and peripheral vasoconstriction have been suggested as important factors. SIPE is characterized by acute onset of dyspnea and cough, sometimes with excessive sputum and hemoptysis. The condition usually resolves spontaneously, but medical attention can be required in more severe cases. Previous studies suggest that SIPE is diagnosed by clinical symptoms, decreased peripheral oxygen saturation and signs of pulmonary edema on lung ultrasound. Interestingly, signs of increased extravascular lung water have been found in divers without respiratory symptoms. There are no similar studies regarding open-water swimmers. This study aims to investigate a large number of swimmers without respiratory symptoms after finishing an open-water swimming race. Prevalence and amount of increased extravascular lung water after swimming will be assessed by lung ultrasound. In addition, individual baseline factors and information about the race associated with increased extravascular lung water will be evaluated. This study will provide better understanding of the pathophysiological mechanism of SIPE.
Interventions
DIAGNOSTIC_TESTLung ultrasound
Four chest regions for both lungs are scanned by lung ultrasound; a positive region defined by the presence of three or more B-line artifacts. Bilateral or unilateral presence of two or more positive regions define positive interstitial syndrome.
DIAGNOSTIC_TESTPeripheral oxygen saturation
Peripheral oxygen saturation measured by non-invasive pulse oxymetry
DIAGNOSTIC_TESTLung auscultation
Clinical auscultation of lungs
DIAGNOSTIC_TESTBody temperature
Body temperature measured by ear thermometer.
Sponsors
Dalarna County Council, Sweden
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Completion of an open-water swimming race during the "Vansbrosimningen" open-water swimming event * No respiratory symptoms (dyspnea and/or cough) during or right after the race * Age ≥ 18 years
Exclusion criteria
* Presence of respiratory symptoms (dyspnea and/or cough) during or right after the swimming race * Declines participation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of regions presenting B-lines on lung ultrasound | Within 1 hour after termination of swimming | Four chest regions for both lungs are scanned by lung ultrasound; a positive region defined by the presence of three or more B-line artifacts. Assessment of the total number of positive regions. |
| Absolute number of B-lines on lung ultrasound | Within 1 hour after termination of swimming | Four chest regions for both lungs are scanned by lung ultrasound; the absolute number of B-lines in each region is counted. |
| Interstitial syndrome assessed by lung ultrasound (yes/no) | Within 1 hour after termination of swimming | Four chest regions for both lungs are scanned by lung ultrasound; a positive region defined by the presence of three or more B-line artifacts. Bilateral or unilateral presence of two or more positive regions define positive interstitial syndrome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peripheral oxygen saturation | Within 1 hour after termination of swimming | Peripheral oxygen saturation measured by non-invasive pulse oxymetry |
| Number of regions presenting B-lines on lung ultrasound | At follow up within 4 hours after termination of swimming | Four chest regions for both lungs are scanned by lung ultrasound; a positive region defined by the presence of three or more B-line artifacts. Assessment of the total number of positive regions. Performed in individuals with signs of increased extravascular lung water after swimming. |
| Absolute number of B-lines on lung ultrasound | At follow up within 4 hours after termination of swimming | Four chest regions for both lungs are scanned by lung ultrasound; the absolute number of B-lines in each region is counted in individuals with sign of increased extravascular lung water after swimming. Performed in individuals with signs of increased extravascular lung water after swimming. |
| Presence of crackles on lung auscultation (yes/no) | Within 1 hour after termination of swimming | Presence of crackles on lung auscultation |
| Perceived exertion during swimming | Within 1 hour after termination of swimming | Perceived exertion during the swimming race measured by "Borg rating of perceived exertion scale". Values on the scale range from a minimum value of 6 (no exertion) to a maximum value of 20 (maximal exertion). |
| Body temperature | Within 1 hour after termination of swimming | Body temperature measured by ear thermometer |
| Interstitial syndrome assessed by lung ultrasound (yes/no) | At follow up within 4 hours after termination of swimming | Four chest regions for both lungs are scanned by lung ultrasound; a positive region defined by the presence of three or more B-line artifacts. Bilateral or unilateral presence of two or more positive regions define positive interstitial syndrome. Performed in individuals with signs of increased extravascular lung water after swimming. |
Countries
Sweden
Outcome results
None listed