Page 111 - JSOM Summer 2023

SIPE. When the patient did not improve on supplemental ox- Acknowledgements
ygen therapy and pulse oximetry reading was normal, this di- None.
agnosis became much less likely, and the DMT transported the
patient to the Emergency Department. Disclaimer
The views expressed are those of the author(s) and do not re-
SIPE typically occurs in Combat Swimmers, triathletes, and flect the official policy of Madigan Army Medical Center, 1st
physically fit males without comorbidities. Cold water, pres- Special Forces Group, United States Army Special Operations
sure differential between mouth above water and lungs be- Command, United States Army Medical Command, the De-
low, and wetsuits may cause shunting of peripheral blood to partment of the Army, the Department of Defense, or the US
central circulation. This shunting causes volume overload in Government. The investigators have adhered to the policies
the pulmonary vasculature and transudative pulmonary cap- for protection of human subjects as prescribed in 45 CFR 46.
illary leakage, leading to pulmonary edema. Further exacer-
bating this increased volume in the central circulation is the References
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patients being female, contrary to the conventional teaching. physiologic implications, clinical presentations, and treatment.
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mia secondary to acute respiratory alkalosis should be con- ment of hypocalcemia. Endocrine. 2020;69(3):485–495.
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CPT Davis and LTC McGrane directly cared for the patient 2021;41:104–109.
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subject matter expertise on combat swimmer injuries, which edema. Chest. 2021;160(5):1594–1595.
has significant influence on the production of the discussion 19. Hårdstedt M, Kristiansson L, Seiler C, Braman Eriksson A, Sundh
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study based on 47,600 open-water swimming distances. Chest.
final reviewer and senior physician on the report and contrib- 2021;160(5):1789–1798.
uted his subject matter expertise as a Fellow in the Academy 20. Volk C, Spiro J, Boswell G, et al. Incidence and impact of
of Wilderness Medicine. swimming-induced pulmonary edema on Navy SEAL candidates.
Chest. 2021;159(5):1934–1941.
Funding/Conflict of Interest
None. PMID: 37084414; DOI: PMWA-GHDT

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