{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T23:32:00Z","timestamp":1793489520356,"version":"4.5.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Divers Alert Network","award":["AUAS\/DAN Diving Medicine Scholarship"],"award-info":[{"award-number":["AUAS\/DAN Diving Medicine Scholarship"]}]},{"name":"Divers Alert Network","award":["Alfred Bove Research Grant for Cardiac Health in S"],"award-info":[{"award-number":["Alfred Bove Research Grant for Cardiac Health in S"]}]},{"DOI":"10.13039\/100007911","name":"University of California, San Diego","doi-asserted-by":"publisher","award":["Center for Excellence in Diving"],"award-info":[{"award-number":["Center for Excellence in Diving"]}],"id":[{"id":"10.13039\/100007911","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>B-lines on lung ultrasound have been found in asymptomatic competitive breath-hold divers, but their significance and time to resolution are not well understood. We sought to investigate the relationship between B-lines, oxygen saturation, and respiratory symptoms after competitive dives to diagnose pulmonary injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed lung ultrasounds before (predive), immediately after (postdive), and within 1 h (follow-up) of a competitive dive. B-lines were counted in each intercostal space in the anterior, lateral, and posterior lung fields, and the highest number of B-lines within a space was recorded for each lung region. At follow-up, each diver's oxygen saturation and respiratory symptoms were recorded. Statistical analysis included the Kruskal\u2013Wallis test, Spearman's correlation, and sensitivity and specificity calculations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty-four divers completed 143 individual dives of four different disciplines. The median number of B-lines was 0 (IQR inclusive=0) predive, 1 (IQR=3) postdive, and 0 (IQR=1) at follow-up. There was a significant difference in total B-lines between measurement times ( p&lt;0.001). Sensitivity and specificity of hypoxemia, clinically significant B-lines, and both measures in tandem in detecting respiratory symptomatology were 52% and 76%, 24% and 92%, and 24% and 95%, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>B-lines are a common phenomenon in competitive breath-hold divers on surfacing and decrease within 1 h, suggesting a physiologic fluid shift. B-lines are negatively correlated with oxygen saturation, indicating that extravascular fluid impairs gas exchange in the lung. Neither hypoxemia nor clinically significant B-lines were found to be reliable indicators for respiratory symptomatology, suggesting that there may be multiple phenotypes of freediving-induced pulmonary syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10806032241281463","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T03:51:03Z","timestamp":1726458663000},"page":"409-416","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Lung Ultrasound as an Adjunct to Pulse Oximetry and Respiratory Symptoms in the Diagnosis of Freediving-Induced Pulmonary Syndrome"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4900-4913","authenticated-orcid":false,"given":"Elaine","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, University of California, San Diego, San Diego, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Kaiser Permanente, Vacaville Medical Center, Vacaville, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Lussier","sequence":"additional","affiliation":[{"name":"University of California, San Diego, School of Medicine, La Jolla, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lindholm","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, University of California, San Diego, San Diego, CA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"bibr1-10806032241281463","first-page":"95","volume-title":"Proceedings of the Barotrauma and SIPE in Freediving Workshop","author":"Lindholm P.","year":"2024"},{"key":"bibr2-10806032241281463","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.711798"},{"key":"bibr3-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.04.028"},{"key":"bibr4-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.08.001"},{"key":"bibr5-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-010-1697-y"},{"key":"bibr6-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-010-0347-z"},{"key":"bibr7-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2009.04.013"},{"key":"bibr8-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00749.2006"},{"key":"bibr9-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2010.01791.x"},{"issue":"10","key":"bibr10-10806032241281463","volume":"14","author":"Allen MF","year":"2022","journal-title":"Cureus"},{"key":"bibr11-10806032241281463","unstructured":"Medical & Science Committee of AIDA International.\n                      SQUEEZE\n                      . May 8, 2019.https:\/\/drive.google.com\/drive\/folders\/1BO4mOmdg7quG_3-mMIVofqwuyTWSEaiS. Accessed: January 27, 2024."},{"key":"bibr12-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000001168"},{"key":"bibr13-10806032241281463","doi-asserted-by":"publisher","DOI":"10.15557\/JoU.2021.0036"},{"issue":"1","key":"bibr14-10806032241281463","first-page":"224","volume":"59","author":"Schagatay EKA","year":"2009","journal-title":"J Physiol Sci"},{"key":"bibr15-10806032241281463","doi-asserted-by":"publisher","DOI":"10.28920\/dhm51.3.299-302"},{"key":"bibr16-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201803-0581IM"},{"key":"bibr17-10806032241281463","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-005-1358-8"},{"key":"bibr18-10806032241281463","first-page":"85","volume-title":"Proceedings of Barotrauma and SIPE in Freediving Workshop","author":"Silva F.","year":"2024"}],"container-title":["Wilderness &amp; Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032241281463","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10806032241281463","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032241281463","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:31:54Z","timestamp":1777689114000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10806032241281463"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,16]]},"references-count":18,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1177\/10806032241281463"],"URL":"https:\/\/doi.org\/10.1177\/10806032241281463","relation":{},"ISSN":["1080-6032","1545-1534"],"issn-type":[{"value":"1080-6032","type":"print"},{"value":"1545-1534","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,16]]}}}