Acute pulmonary edema has been associated with cold-water immersion
in swimmers and divers. We report on eight divers using a
self-contained underwater breathing apparatus (scuba) who developed
acute pulmonary edema manifested by dyspnea, hypoxemia, and
characteristic chest radiographic findings. All cases occurred in cold
water. All scuba divers were treated with complete resolution, and
three have returned to diving without further episodes. Mechanisms that
would contribute to a raised capillary transmural pressure or to a
reduced blood-gas barrier function or integrity are discussed.
Pulmonary edema in scuba divers is multifactorial, and constitutional
factors may play a role. Physicians should be aware of this potential,
likely underreported, problem in scuba divers.