Physiotherapy for Swimming-Induced Pulmonary Oedema

Swimming-induced pulmonary oedema is likely to become a common problem with increasing popularity of endurance sports such as triathlon. Also known as immersion pulmonary oedema, it was first reported in the 1980s in healthy scuba divers. Ever since, there have been hundreds of reported cases in triathletes, swimmers, and divers which include death.

What is Swimming-Induced Pulmonary Oedema?

The lungs are responsible for taking oxygen from the air that you breathe and putting that oxygen into the bloodstream. However, in fluid-filled lungs, such as in cases of pulmonary oedema, the lungs cannot put oxygen into the bloodstream, and the rest of the body is deprived of oxygen.

Swimming-induced pulmonary oedema is the abnormal leak of fluids from the blood via the small vessels of the lung referred to as pulmonary capillaries, into the airspaces known as alveoli.

Alveoli are where the oxygen from the air is picked up by the blood passing by, and carbon dioxide in the blood is passed into the alveoli to be exhaled out. They normally have thin wall that allows for this gas exchange, and fluids are usually kept out of the alveoli unless these walls lose their integrity.

In a lung affected with pulmonary oedema, the alveoli fill up with excess fluid seeped out of the pulmonary capillaries instead of air. This can cause in problems with gas exchange involving oxygen and carbon dioxide and result in difficulty of breathing and poor oxygenation of blood. Sometimes, this can be referred to as “water in the lungs” when describing the condition to patients.

A person with swimming-induced pulmonary oedema may experience symptoms such as acute shortness of breath, absence of water aspiration, and cough that often produce copious pink frothy sputum.

Swimming-induced pulmonary oedema occurs during heavy exertion in conditions of water immersion, such as swimming and diving. People who are prone to this type of pulmonary oedema are scuba divers, apnea (breath-hold) free-divers, combat swimmers, and triathletes.

Swimming-induced pulmonary oedema has been referred to as an acute pulmonary oedema. An acute pulmonary oedema, the one that develops suddenly, requires immediate care. Although sometimes prove fatal, the outlook improves with prompt treatment for pulmomary oedema with treatment for the underlying problem. The treatment for pulmonary oedema generally includes supplemental oxygen and medications.

What is the Role of Physiotherapy?

Physiotherapy represents an integral part of the management of patients with respiratory insufficiency, who may be mechanically ventilated and are cared for in a respiratory intensive care units. Physiotherapists are one of the healthcare professionals who play an important role in the medical management of acute pulmonary oedema. They prescribe a variety of ventilator exercises which greatly improve the symptoms of a patient.

The aim of physiotherapy program for patients with pulmonary oedema is to enhance their functional capacity and to restore their respiratory and physical independence. Physiotherapy helps reduce the risk of bed-rest associated complications. If started early, physiotherapy helps prevent weaning delay, limited mobility and complete dependence on the ventilator.

The occurrence of swimming-induced pulmonary oedema needs increased awareness by participants, organizers, and medical care, especially if individuals are at increased risk of future life-threatening episodes and drowning if not given with accurate diagnosis and appropriate advice.

If you suffer from respiratory problems such as swimming-induced pulmonary oedema, we can help by prescribing exercises to improve your respiratory health. Call us today at 9444 8729.