#137 | Bizo Silva | Lung Ultrasound, Squeeze and Lung Health

The Freedive Cafe Podcast

Bizo Silva is an Emergency Medicine physician practicing in a trauma center in Northern California, USA. He specialized in lung ultrasound in trauma. Bizo took part in much of the basic research and development of methods on how lung ultrasound is practiced today.

After working for a few years in a very busy trauma center in Brazil, he moved to the USA in 2007. He discovered freediving on a vacation to Hawaii, and shortly after decided to shift careers towards freediving medicine after he was blown away by the fascinating physiology of this unusual sport.
In this episode we discuss:
Bizo grew up in Brazil, went to med school there.
He met his partner in New York and has lived in the US for 17 years.
He has a masters in lung ultrasound and contusion.
At what point did freediving enter his life?
He started getting interested in freediving while on a trip to Hawaii.
Took a level 1 courses with Ben Zyons.
The difference between lung contusion and pulmonary barotrauma.
Clarifying the term 'oedema', compared to contusion.
Call back to Ep#21 with Ron Chapman, discussing the death of Nick Mevoli.
What does 'lung squeeze' mean, exactly? (we don't know).
What is remodelling of the vasculature around the alveoli?
Not only a vasogenic adaptation, but also structural changes in walls of blood vessels.
Shout out to Aharon Solomons and Tommy and Happy Birthday!
Shout out to Juani Valdivia!
What changes happen in the structure of lungs in high altitude situations?
Altitude pulmonary oedema quite similar to lung squeeze.
The gradation of different levels of lung squeeze. Not only hydrostatic stress but also sheer stress.
Comparing CT scans and lung ultrasound.
A portable lung ultrasound attachment for an iPad can be had for around 2-3k.
Link to lung ultrasound study I participated in during the 2022 Taiwanese Cup.
What issues did Bizo bring up with that study?
What are B-lines? Why are they not the same thing as lung comets. Clarifying the terminology.
How informative are lung ultrasounds to the trained observer?
How quickly can the lung recover as long as there is no structural rupture.
Development of condition similar to scar tissue/'pulmonary fibrosis'
Why do some people squeeze more than other?
Comparing the lungs of healthy individual smokers to long-term smokers.
Donny's history with smoking.
Uniformity of lung injury is important.
Can a lung ultrasound detect COPD?
Lung ultrasounds can only see the surface of the lungs.
What was problematic about the conclusions of the lung ultrasound study?
How ultrasound really works.
Donny's lung ultrasound images.
What is atelectasis and how does it generate B-lines?
What is the value of checking SaO2 (oxygen saturation) after dives?
What is CPAP and what can it do for us?
The problem with pure O2!
What is the benefit of recovery breath and should we still do it?
Should we pack after the dive?
Anecdote of a man who saved himself from heart attack with coughing.
What is SIPE (swimming induced pulmonary oedema)?
Difficulty of monitoring O2 and doing lung ultrasound while in the water.
What is the current state of competition medical care?
DESERT ISLAND QUESTIONS - PATREON EXCLUSIVE
Why does Bizo freedive?

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