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Immersion pulmonary edema

Last edited: 4/15/2026

Overview

Immersion pulmonary edema (IPE) is a rare but potentially life-threatening condition characterized by the sudden onset of dyspnea and hypoxemia in individuals exposed to cold water immersion, often without signs of cardiac pathology 1.

Diagnosis

  • Clinical presentation includes acute onset of dyspnea, cough, frothy sputum, and hypoxemia 1.
  • Chest imaging may reveal bilateral pulmonary infiltrates 1.
  • Echocardiography typically shows normal cardiac function, distinguishing IPE from cardiogenic pulmonary edema 1.
  • Grading systems for severity are not well-defined in the provided abstracts 1.
  • Management

  • Immediate removal from the water and supportive oxygenation are critical 1.
  • Mechanical ventilation may be required in severe cases 1.
  • Diuretics are generally not indicated as IPE is not primarily fluid overload 1.
  • Close monitoring in an intensive care setting is advised for patients with severe symptoms 1.
  • Special Populations

  • No specific data provided in the abstracts regarding pregnancy, pediatrics, elderly, or comorbidities 12.
  • Key Recommendations

  • Rapid extrication from cold water and provision of supplemental oxygen (Evidence: Expert opinion) 1
  • Utilize mechanical ventilation if hypoxemia is severe and refractory to supplemental oxygen (Evidence: Expert opinion) 1
  • Avoid diuretic therapy as IPE is not typically fluid overload-related (Evidence: Expert opinion) 1
  • References

    1 Dobson JL. Effect of uniform versus expanding retrieval practice on the recall of physiology information. Advances in physiology education 2012. link 2 Kordas M, Lajovic J. Personal computers in teaching quantitative aspects in undergraduate physiology. Medical education 1987. link

    Original source

    1. [1]
    2. [2]

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