Document Detail

Do changes in lung function predict high-altitude pulmonary edema at an early stage?
MedLine Citation:
PMID:  16960516     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Ascent to high altitude is associated with alterations in lung function. The mechanisms of these changes and whether they reflect early stages of high-altitude pulmonary edema (HAPE) has been debated. Therefore, we investigated the time course of pulmonary function in relation to hemodynamics and clinical symptoms in mountaineers ascending rapidly to high altitude. METHODS: In 26 unacclimatized subjects we assessed spirometry, single-breath nitrogen washout, diffusing capacity (DLCO), and Doppler echocardiography in Zurich, 490 m, after climbing within 24 h to Monte Rosa, 4559 m, and after one night at 4559 m. RESULTS: Mean (+/- SD) FVC fell from 103 +/- 9% predicted in Zurich to 96 +/- 10% predicted at 4559 m, FEV1/FVC increased from 0.82 +/- 0.06 to 0.84 +/- 0.08, and closing volume increased from 0.35 +/- 0.14 to 0.44 +/- 0.11 L above residual volume (P < 0.05, all changes). On the following day at 4559 m, closing volume remained elevated in 9 of 21 subjects who had a lower DLCO but similar pulmonary artery systolic pressures compared with the remaining 12 subjects (40 +/- 8 vs 43 +/- 7 mm Hg, P = NS). None of the subjects had overt HAPE. CONCLUSION: We conclude that changes in pulmonary function after rapid ascent to high altitude were consistent with interstitial fluid accumulation, but they were not related to changes in pulmonary artery pressure. Individual lung function responses to high-altitude exposure varied largely and did not predict subsequent HAPE.
Oliver Senn; Christian F Clarenbach; Manuel Fischler; Rahel Thalmann; Hanspeter Brunner-La Rocca; Patrick Egger; Marco Maggiorini; Konrad E Bloch
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Medicine and science in sports and exercise     Volume:  38     ISSN:  0195-9131     ISO Abbreviation:  Med Sci Sports Exerc     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-08     Completed Date:  2006-12-12     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8005433     Medline TA:  Med Sci Sports Exerc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1565-70     Citation Subset:  IM; S    
Pulmonary Division, University Hospital of Zurich and Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
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MeSH Terms
Altitude Sickness / blood,  physiopathology*
Anoxia / blood,  physiopathology*
Blood Pressure / physiology*
Cardiac Output / physiology*
Echocardiography, Doppler
Lung / physiology
Lung Volume Measurements / methods
Physical Exertion / physiology*
Predictive Value of Tests
Pulmonary Edema / etiology,  physiopathology*
Severity of Illness Index

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