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1 of Physiology + Pharmacology, Environmental Physiology, Karolinska Institutet, Stockholm, Sweden
2 Karolinska Hospital, Karolinska Institutet, Dept of Otorinolaryngology, Head and Neck surgery, Stockholm, Sweden
3 Defence medicine, FOI, Stockholm, Sweden
* To whom correspondence should be addressed. E-mail: peter.lindholm{at}ki.se.
To simulate pressure effects and experience thoracic compression while breath-hold diving in a relatively safe environment, competitive breath hold divers exhale to residual volume before diving in a swimming pool, thus compressing the chest even at depth of only 3 - 6 meters. The study was undertaken to investigate whether such diving could cause pulmonary edema and haemoptysis. 11 volunteer breath-hold divers who regularly dive on full exhalation performed repeated dives to 6 m during a 20 min period. The subjects were studied with dynamic spirometry, video-fibernaso-laryngoscopy, and single breath diffusion capacity (DL,CO). The duration of dives with empty lungs ranged 30-120 seconds. Post diving forced vital capacity was reduced from mean (SD) 6.57±0.88 L to 6.23±1.02 L, p<0.05 and forced expiratory volume (FEV1.0) was reduced from 5.09±0.64 L to 4.59 ±0.72 L, p<0.001, n=11. FEV1/FVC was 0.78±0.05 pre diving and 0.74±0.05 post diving p<0.001, n=11. All subjects reported a (reversible) change in their voice after diving,irritation and slight congestion in the larynx. Fresh blood which originated from somewhere below the vocal cords was found by laryngoscopy in 2 subjects. DL,CO/VA was 1.56±0.17 mmol*kPa-1*min-1*l-1 prior to diving. After diving the DL,CO/VA increased to 1.72±0.24, p=0.001, but 20 minutes later it was indistinguishable from the pre-dive value: 1.57±0.20, n=11. Breath-hold diving with empty lungs to shallow depths can induce haemoptysis in healthy subjects. Edema was possibly present in the lower airways, as suggested by reduced dynamic spirometry.
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