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Table 2 Study characteristics and outcomes of the clinical studies

From: Swimming induced pulmonary oedema in athletes – a systematic review and best evidence synthesis

Caillaud 1995 Pulmonary function DLCO, KCO, VA, Pulmonary Volume (CT), MLD Pre- and post Olympic Triathlon
Water temperature 14 °C
No change in VC and TLC, DLCO and KCO reduced, slight increase in extrapulmonary water, significant increase in MLD
Choi 2004 Arrythmia Long QT syndrome   Genetic testing LQTS +CPVT1 gene present in 90.7% swimming triggered events
Ludwig 2006 Pulmonary function TLC, VC, FEV1, FEV1/FVC, DLCO Non randomized study, testing following cycle ergometry, SIPE subjects versus control group No difference between groups
Wester 2009 Pulmonary function VT, VO2, VE, VD/VT, VCO2, Ph, PCO2, PO2, MAP, MPAP, PAWP, CVP Dry and immersion exercise in cold (19 °C) and warm (28 °C) MPAP, CVP higher in cold water
Fraser 2010 Pulmonary function VC, FEV1, FEV25–75, HCVR, VO2max, PAP, MAP, MPAP, CVP Cold water immersions (20-21 °C)
Hyper vs normoxia
Cold water immersion associated with higher mean PAP, PVR, MPAP favouring conditions for pulmonary oedema, PAWP approached threshold to pulmonary capillary leak pressures
Harris 2010 Deaths in Triathlons Heart Morphology Autopsy (n = 9) 7 left VH, 1 congenital coronary artery anomaly
Pingitore 2011 Echocardiography, Chest Ultrasound, Pulmonary function VC, FEV1, Troponin, IL
LV systolic function and volume
Pre- and post Ironman event Transient and interstitial pulmonary oedema in all athletes
Moon 2016 Deaths in Triathlons Heart mass, ventricular thickness, coronary abnormalities Autopsy (n = 23) 95% heart mass > than normal, 23 > 70% CAD narrowing, 32% > 50%CAD narrowing
Moon 2016 Pulmonary function CVP, MAP, MPAP, PAWP Submersion in 20 °C water CVP 23% increase, PAWP 25% increase, MPAP 26% increase, MAP 7% increase
Shearer 2009 Brain natriuretic peptide (BNP) BNP BNP levels in 6 cases confirmed with SIPE in the ER Within normal for all subjects