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Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema

INTRODUCTION: The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage. METHODS: In 18 m...

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Autores principales: Clarenbach, Christian F., Senn, Oliver, Christ, Andreas L., Fischler, Manuel, Maggiorini, Marco, Bloch, Konrad E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400591/
https://www.ncbi.nlm.nih.gov/pubmed/22829927
http://dx.doi.org/10.1371/journal.pone.0041188
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author Clarenbach, Christian F.
Senn, Oliver
Christ, Andreas L.
Fischler, Manuel
Maggiorini, Marco
Bloch, Konrad E.
author_facet Clarenbach, Christian F.
Senn, Oliver
Christ, Andreas L.
Fischler, Manuel
Maggiorini, Marco
Bloch, Konrad E.
author_sort Clarenbach, Christian F.
collection PubMed
description INTRODUCTION: The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage. METHODS: In 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days after rapid ascent to 4559 m. Findings were compared among subjects developing HAPE and those remaining well (controls). RESULTS: In 8 subjects subsequently developing radiographically documented HAPE at 4559 m, median FVC declined to 82% of low altitude baseline while closing volume increased to 164% of baseline (P<0.05, both instances). In 10 controls, FVC decreased slightly (to 93% baseline, P<0.05) but significantly less than in subjects with HAPE and closing volume remained unchanged. Sniff nasal pressure was reduced in both subjects with and without subsequent HAPE. During nights at 4559 m, mean nocturnal oxygen saturation dropped to lower values while minute ventilation, the number of periodic breathing cycles and heart rate were higher (60%; 8.6 L/min; 97 cycles/h; 94 beats/min, respectively) in subjects subsequently developing HAPE than in controls (73%; 5.1 L/min; 48 cycles/h; 79 beats/min; P<0.05 vs. HAPE, all instances). CONCLUSION: The results comprehensively represent the pattern of physiologic alterations that precede overt HAPE. The changes in lung function are consistent with reduced lung compliance and impaired gas exchange. Pronounced nocturnal hypoxemia, ventilatory control instability and sympathetic stimulation are further signs of subsequent overt HAPE. REGISTRATION: ClinicalTrials.gov identifier: NCT00274430
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spelling pubmed-34005912012-07-24 Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema Clarenbach, Christian F. Senn, Oliver Christ, Andreas L. Fischler, Manuel Maggiorini, Marco Bloch, Konrad E. PLoS One Research Article INTRODUCTION: The purpose of the study was to comprehensively evaluate physiologic changes associated with development of high altitude pulmonary edema (HAPE). We tested whether changes in pulmonary function and breathing pattern would herald clinically overt HAPE at an early stage. METHODS: In 18 mountaineers, spirometry, diffusing capacity, nitrogen washout, nocturnal ventilation and pulse oximetry were recorded at 490 m and during 3 days after rapid ascent to 4559 m. Findings were compared among subjects developing HAPE and those remaining well (controls). RESULTS: In 8 subjects subsequently developing radiographically documented HAPE at 4559 m, median FVC declined to 82% of low altitude baseline while closing volume increased to 164% of baseline (P<0.05, both instances). In 10 controls, FVC decreased slightly (to 93% baseline, P<0.05) but significantly less than in subjects with HAPE and closing volume remained unchanged. Sniff nasal pressure was reduced in both subjects with and without subsequent HAPE. During nights at 4559 m, mean nocturnal oxygen saturation dropped to lower values while minute ventilation, the number of periodic breathing cycles and heart rate were higher (60%; 8.6 L/min; 97 cycles/h; 94 beats/min, respectively) in subjects subsequently developing HAPE than in controls (73%; 5.1 L/min; 48 cycles/h; 79 beats/min; P<0.05 vs. HAPE, all instances). CONCLUSION: The results comprehensively represent the pattern of physiologic alterations that precede overt HAPE. The changes in lung function are consistent with reduced lung compliance and impaired gas exchange. Pronounced nocturnal hypoxemia, ventilatory control instability and sympathetic stimulation are further signs of subsequent overt HAPE. REGISTRATION: ClinicalTrials.gov identifier: NCT00274430 Public Library of Science 2012-07-19 /pmc/articles/PMC3400591/ /pubmed/22829927 http://dx.doi.org/10.1371/journal.pone.0041188 Text en Clarenbach et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Clarenbach, Christian F.
Senn, Oliver
Christ, Andreas L.
Fischler, Manuel
Maggiorini, Marco
Bloch, Konrad E.
Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema
title Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema
title_full Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema
title_fullStr Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema
title_full_unstemmed Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema
title_short Lung Function and Breathing Pattern in Subjects Developing High Altitude Pulmonary Edema
title_sort lung function and breathing pattern in subjects developing high altitude pulmonary edema
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400591/
https://www.ncbi.nlm.nih.gov/pubmed/22829927
http://dx.doi.org/10.1371/journal.pone.0041188
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