Key result
Sildenafil premedication linked to ~22% improved ventilatory efficiency and no swimming-induced pulmonary edema recurrence.
Case Report (n=1)
No
Absolute Event Rate: 35% vs 45%
Highlights the risk factors and pathophysiology of swimming-induced pulmonary edema, emphasizing prevention as the primary management strategy.
May guide individualized SIPE prevention; leaves open prospective trials before practice change.
Swimming-induced pulmonary edema is a leading cause of triathlon-associated emergencies and death. Cold water immersion, female sex, age>50, and wetsuit compression are associated risk factors. Pathophysiology is due to increased central blood pooling, leading to increased pulmonary capillary wedge pressure. Treatment is focused on prevention; however, recurrence is common. (Level of Difficulty: Intermediate.)
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Lili A. Barouch (2022) conducted a case report in Swimming-Induced Pulmonary Edema (n=1). Sildenafil and Furosemide premedication vs. No premedication was evaluated on Ventilatory efficiency (VE/VCO2 slope). Premedication with 50 mg sildenafil improved ventilatory efficiency, and combined with furosemide and behavioral modifications, prevented recurrence of swimming-induced pulmonary edema.
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