Key result
Oral sildenafil 50 mg before swimming reduced mean pulmonary artery pressure from 35.3 to 28.8 mm Hg and prevented SIPE recurrence during 20 subsequent triathlons in a susceptible athlete.
Why the study?
Does oral sildenafil prevent swimming-induced pulmonary edema in susceptible individuals?
Case Report (n=1)
Does oral sildenafil prevent swimming-induced pulmonary edema in susceptible individuals?
Sildenafil 50 mg taken before swimming may effectively prevent swimming-induced pulmonary edema by lowering pulmonary artery and wedge pressures.
May support pre-swim sildenafil in recurrent SIPE; hypothesis-generating case report requires prospective validation.
Swimming-induced pulmonary edema (SIPE) occurs during swimming and scuba diving, usually in cold water, in susceptible healthy individuals, especially military recruits and triathletes. We have previously demonstrated that pulmonary artery (PA) pressure and PA wedge pressure are higher during immersed exercise in SIPE-susceptible individuals versus controls, confirming that SIPE is a form of hemodynamic pulmonary edema. Oral sildenafil 50 mg 1 h before immersed exercise reduced PA pressure and PA wedge pressure, suggesting that sildenafil may prevent SIPE. We present a case of a 46-yr-old female ultratriathlete with a history of at least five SIPE episodes. During a study of an exercise submerged in 20°C water, physiological parameters before and after sildenafil 50 mg orally were as follows: O2 consumption 1.75, 1.76 L·min; HR 129, 135 bpm; arterial pressure 189/88 (mean 121.5), 172/85 (mean 114.3) mm Hg; mean PA pressure 35.3, 28.8 mm Hg; and PA wedge pressure 25.3, 19.7 mm Hg. She has had no recurrences during 20 subsequent triathlons while taking 50 mg sildenafil before each swim. This case supports sildenafil as an effective prophylactic agent against SIPE during competitive surface swimming.
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Martina et al. (2017) conducted a case report in Swimming-induced pulmonary edema (SIPE) (n=1). Sildenafil vs. Baseline (before sildenafil) was evaluated on Physiological parameters (including pulmonary artery pressure) and SIPE recurrence. Oral sildenafil 50 mg before swimming reduced mean pulmonary artery pressure from 35.3 to 28.8 mm Hg and prevented SIPE recurrence during 20 subsequent triathlons in a susceptible athlete.
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