Understanding symptoms of swimming-induced pulmonary edema through the patient's perspective: a qualitative approach

Abstract Objectives Swimming-induced pulmonary edema (SIPE)ddSIPE = swimming-induced pulmonary edema² OWS = open water swimming is a potentially fatal condition that can develop in healthy individuals during swimming. Detailed descriptions of episode onset to resolution are lacking but needed to facilitate early recognition and support swimmer safety. We aimed to explore personal accounts of SIPE, focusing on the symptoms. Design Qualitative descriptive exploratory study using semi-structured interviews. Methods We subjected interview data from seventeen individuals who have experienced SIPE to thematic analysis. Sample size was guided by the concept of information power. Results Eight symptom themes were identified, categorised under respiratory symptoms (noisy breathing, cough, chest tightness and dyspnoea) or non-respiratory symptoms (physical fatigue, altered mental state, difficulty with urination, and lack of cold perception). Conclusions Symptoms varied widely, and early or non-specific symptoms may be perceived as benign by swimmers who are unfamiliar with SIPE or less experienced with marathon swimming. Our findings also identified non-classical symptoms that may support early recognition.