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AI-DRAFTED — PHYSICIAN REVIEW IN PROGRESSThe citation for this entry was checked against Crossref and PubMed, but its summary and interpretation were drafted by an AI model from the published abstract and have not yet been individually read by a physician. Read the linked source before relying on this operationally.
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Clinical severity of immersion pulmonary edema: A 14-year cohort study[1]

Kociuba M, Morin J, Marchi J, Amara J, Wolff D, Texier G, Gempp E, Blatteau JE · 2026 · Am J Emerg Med

Summary

Retrospective cohort of all 288 immersion pulmonary edema (IPE) cases at a French national hyperbaric referral center, 2010-2023. 90 patients (31.3%) presented with SEVERE manifestations — acute respiratory distress (63.4%), loss of consciousness (32.2%), cardiac arrest (4.4%). Exposure split: scuba 79.9%, breath-hold 11.8%, surface swimming 8.3%. No strong independent severity predictor emerged (active smoking borderline, adjusted OR 2.77, p=0.053); among scuba divers, shorter dive and incomplete decompression tracked severity. Conclusion: nearly a third of IPE is life-threatening and severity is hard to anticipate — high index of suspicion required.

So what

The acuity case for taking immersion pulmonary edema seriously at water events: a third of cases are severe and there is NO reliable way to predict which — so any swimmer with post-immersion dyspnea is a potential emergency, and event medical cover on open-water swims must carry oxygen and airway capability, not just a towel. The largest IPE severity cohort published; complements the SIPE scoping review (Steins) with hard proportions, and gives the water-events shelf its clinical spine.

Key findings

  • 288 IPE cases over 14 years - largest severity cohort
  • 31.3% severe: respiratory distress 63.4%, LOC 32.2%, cardiac arrest 4.4%
  • No strong independent severity predictor (smoking borderline OR 2.77)
  • Scuba 79.9% / breath-hold 11.8% / surface swimming 8.3%
  • Unpredictable severity - mandates high suspicion + O2/airway on water cover

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