{"id":33061,"date":"2025-09-25T09:09:31","date_gmt":"2025-09-25T13:09:31","guid":{"rendered":"https:\/\/world.dan.org\/?post_type=dan_divers_blog&p=33061"},"modified":"2025-09-25T09:30:34","modified_gmt":"2025-09-25T13:30:34","slug":"understanding-squeeze-new-study-surveys-breath-hold-divers","status":"publish","type":"dan_divers_blog","link":"https:\/\/world.dan.org\/fr\/safety-prevention\/diver-safety\/divers-blog\/understanding-squeeze-new-study-surveys-breath-hold-divers\/","title":{"rendered":"Comprendre le \u00ab Squeeze \u00bb : une nouvelle \u00e9tude aupr\u00e8s des apn\u00e9istes"},"content":{"rendered":"

Les plongeurs associent g\u00e9n\u00e9ralement le terme \u00ab squeeze \u00bb \u00e0 une l\u00e9sion li\u00e9e \u00e0 la pression (barotraumatisme) touchant les oreilles, les sinus ou les yeux. En apn\u00e9e, le terme est couramment utilis\u00e9 pour d\u00e9signer une l\u00e9sion pulmonaire. <\/p>\n\n\n\n

Beaucoup d\u2019apn\u00e9istes connaissent la notion de squeeze, mais la mani\u00e8re dont ce ph\u00e9nom\u00e8ne survient et ses causes ne sont pas encore pleinement comprises. En 2023, DAN s\u2019est associ\u00e9 \u00e0 l\u2019Universit\u00e9 de Californie \u00e0 San Diego pour interroger des apn\u00e9istes sur leurs exp\u00e9riences de l\u00e9sions pulmonaires (\u00ab squeeze \u00bb) et sur leur retour \u00e0 l\u2019apn\u00e9e par la suite. L\u2019\u00e9tude visait \u00e0 identifier des tendances dans les sympt\u00f4mes, les causes possibles et les sch\u00e9mas de r\u00e9cup\u00e9ration \u2014 afin de promouvoir des pratiques plus s\u00fbres et de fournir des recommandations plus claires pour la prise en charge d\u2019un squeeze.<\/p>\n\n\n\n

Qu\u2019est-ce que le Squeeze ?<\/strong><\/h3>\n\n\n\n

Lorsqu\u2019un apn\u00e9iste descend, la pression de l\u2019eau comprime les poumons dans la cage thoracique. Si cette compression d\u00e9passe la capacit\u00e9 de compensation du corps, elle peut provoquer un stress ou des l\u00e9sions du tissu pulmonaire, comme de petites fuites ou d\u00e9chirures. Cela peut entra\u00eener un barotraumatisme pulmonaire ou une accumulation de liquide dans les poumons (\u0153d\u00e8me pulmonaire), provoquant des sympt\u00f4mes tels que toux (avec ou sans sang), oppression thoracique, essoufflement, fatigue ou \u00e9tourdissements.<\/p>\n\n\n

\n
\"Pulmonary<\/figure>\n<\/div>\n\n\n

Selon les conclusions de l\u2019atelier SCED\/DAN 2023 sur le barotraumatisme et le SIPE en apn\u00e9e<\/a>, ces sympt\u00f4mes s\u2019inscrivent dans le cadre du Freediving-Induced Pulmonary Syndrome (FIPS) \u2014 un terme propos\u00e9 pour englober l\u2019ensemble du spectre des sympt\u00f4mes respiratoires li\u00e9s \u00e0 l\u2019apn\u00e9e, en particulier lorsque le m\u00e9canisme exact de la l\u00e9sion est incertain ou multifactoriel. Les sous-types suspect\u00e9s du FIPS incluent l\u2019\u0153d\u00e8me pulmonaire, l\u2019\u0153d\u00e8me et\/ou l\u2019h\u00e9morragie trach\u00e9ale ou laryng\u00e9e, ainsi que le barotraumatisme alv\u00e9olaire.<\/p>\n\n\n\n

Les chercheurs et sp\u00e9cialistes de la m\u00e9decine de plong\u00e9e continuent d\u2019affiner cette classification et d\u2019explorer les voies de traitement.<\/p>\n\n\n\n

L\u2019enqu\u00eate<\/strong><\/h3>\n\n\n\n

Pour mieux comprendre comment les apn\u00e9istes vivent et r\u00e9cup\u00e8rent apr\u00e8s un squeeze, DAN a lanc\u00e9 une enqu\u00eate en ligne de deux mois en 2023. Au total, 132 apn\u00e9istes ont r\u00e9pondu \u2014 en majorit\u00e9 des apn\u00e9istes r\u00e9cr\u00e9atifs et comp\u00e9titifs \u2014 dont 98 % titulaires d\u2019une certification officielle. Parmi eux, 96 % ont rapport\u00e9 au moins un \u00e9pisode de squeeze entre 2008 et 2023, ce qui repr\u00e9sente 140 \u00e9v\u00e9nements analys\u00e9s dans cette \u00e9tude. De nombreux participants ont signal\u00e9 des incidents r\u00e9p\u00e9t\u00e9s, avec une moyenne de 8 \u00b1 20 squeezes au cours de leur parcours de plong\u00e9e.<\/p>\n\n\n\n

Les r\u00e9pondants pratiquaient diverses activit\u00e9s d\u2019apn\u00e9e, dont la chasse sous-marine et le hockey subaquatique. Parmi les disciplines d\u2019apn\u00e9e, les trois le plus souvent associ\u00e9es aux squeezes \u00e9taient l\u2019immersion libre (FIM), le poids constant avec bi-palmes (CWTB) et le poids constant avec monopalme (CWT). L\u2019immersion libre \u2014 qui implique de se tracter le long du c\u00e2ble et peut g\u00e9n\u00e9rer une contrainte accrue \u2014 repr\u00e9sentait le plus grand nombre d\u2019incidents rapport\u00e9s. Dans la m\u00eame logique, 72 % des \u00e9v\u00e9nements sont survenus lors d\u2019entra\u00eenements, quand les apn\u00e9istes poussaient souvent leurs limites ou perfectionnaient leurs techniques.<\/p>\n\n\n\n

Les profondeurs rapport\u00e9es lors des sympt\u00f4mes de squeeze allaient de 10 \u00e0 113 m\u00e8tres (32\u2013370 pieds), avec une moyenne de 43 \u00b1 22 m\u00e8tres (141 \u00b1 72 pieds). Notamment, la plupart des squeezes se sont produits \u00e0 des profondeurs inf\u00e9rieures au record personnel de l\u2019apn\u00e9iste, ce qui sugg\u00e8re que la profondeur seule n\u2019explique pas le risque. Les causes rapport\u00e9es par les participants \u2014 comme les mouvements en profondeur, les contractions du diaphragme et un \u00e9chauffement insuffisant \u2014 indiquent que la contrainte dynamique et les mouvements thoraciques sous stress jouent un r\u00f4le plus important dans la survenue d\u2019un squeeze.<\/p>\n\n\n\n

Sympt\u00f4mes et r\u00e9cup\u00e9ration<\/strong><\/h3>\n\n\n\n

Les sympt\u00f4mes les plus rapport\u00e9s apr\u00e8s un squeeze \u00e9taient la toux, la production de mucus (expectorations) et la fatigue. Bien que la toux avec sang (h\u00e9moptysie) soit souvent consid\u00e9r\u00e9e comme un signe caract\u00e9ristique de l\u00e9sion pulmonaire, de nombreux participants ont signal\u00e9 des sympt\u00f4mes compatibles avec un squeeze sans pr\u00e9sence visible de sang, indiquant un spectre de l\u00e9sions plus large qu\u2019on ne le reconna\u00eet parfois.<\/p>\n\n\n\n

La plupart des apn\u00e9istes (80 %) n\u2019ont pas recherch\u00e9 de soins m\u00e9dicaux ni re\u00e7u de traitement (y compris l\u2019oxyg\u00e9noth\u00e9rapie) apr\u00e8s un squeeze. Parmi les 36 personnes (26 %) qui ont consult\u00e9, 14 ont \u00e9t\u00e9 hospitalis\u00e9es, avec des examens allant de simples analyses de sang \u00e0 des scanners thoraciques. Cela sugg\u00e8re que, si de nombreux cas sont b\u00e9nins et se r\u00e9solvent spontan\u00e9ment, un sous-groupe peut \u00eatre s\u00e9rieux et n\u00e9cessiter une prise en charge clinique. Toutefois, l\u2019absence de suivi m\u00e9dical syst\u00e9matique rend difficile l\u2019\u00e9valuation d\u2019\u00e9ventuelles s\u00e9quelles non d\u00e9tect\u00e9es dans les cas non trait\u00e9s.<\/p>\n\n\n\n

Les recommandations concernant le d\u00e9lai avant reprise variaient fortement, de quelques jours \u00e0 une ann\u00e9e enti\u00e8re, avec une moyenne de un \u00e0 deux mois. Malgr\u00e9 ces divergences, en moyenne, les apn\u00e9istes ont pu redescendre \u00e0 la profondeur de leur incident dans les trois mois suivant celui-ci.<\/p>\n\n\n\n

Conclusion<\/strong><\/h3>\n\n\n\n

Cette enqu\u00eate sugg\u00e8re que les squeezes sont plus fr\u00e9quents qu\u2019on ne le pensait, souvent non d\u00e9clar\u00e9s et non trait\u00e9s, et pr\u00e9sentent une grande variabilit\u00e9 individuelle en termes de sympt\u00f4mes et de r\u00e9cup\u00e9ration. Si beaucoup d\u2019apn\u00e9istes semblent retrouver leurs capacit\u00e9s, notamment dans les cas b\u00e9nins, l\u2019absence de suivi m\u00e9dical rend difficile l\u2019\u00e9valuation des cons\u00e9quences \u00e0 long terme.<\/p>\n\n\n\n

Des recherches suppl\u00e9mentaires sont n\u00e9cessaires pour \u00e9tablir des crit\u00e8res diagnostiques coh\u00e9rents, des protocoles de traitement et des lignes directrices pour la reprise de l\u2019apn\u00e9e. En attendant, une meilleure sensibilisation aux sympt\u00f4mes et aux risques potentiels peut aider les apn\u00e9istes \u00e0 prendre des d\u00e9cisions plus \u00e9clair\u00e9es concernant leur entra\u00eenement, leurs \u00e9chauffements et leur r\u00e9cup\u00e9ration apr\u00e8s un incident. Les r\u00e9sultats complets de cette \u00e9tude ont \u00e9t\u00e9 publi\u00e9s dans Diving and Hyperbaric Medicine<\/a><\/em>.<\/p>","protected":false},"excerpt":{"rendered":"

Scuba divers typically associate the term \u201csqueeze\u201d with a pressure-related injury (barotrauma) to the ears, sinuses, or eyes. 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