Document Detail


Frequent subclinical high-altitude pulmonary edema detected by chest sonography as ultrasound lung comets in recreational climbers.
MedLine Citation:
PMID:  20562696     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The ultrasound lung comets detected by chest sonography are a simple, noninvasive, semiquantitative sign of increased extravascular lung water. The aim of this study was to evaluate, by chest sonography, the incidence of interstitial pulmonary edema in recreational high-altitude climbers. DESIGN: Observational study. SUBJECTS: Eighteen healthy subjects (mean age 45 +/- 10 yrs, ten males) participating in a high-altitude trek in Nepal. INTERVENTIONS: Chest and cardiac sonography at sea level and at different altitudes during ascent. Ultrasound lung comets were evaluated on anterior chest at 28 predefined scanning sites. MEASUREMENTS AND MAIN RESULTS: At individual patient analysis, ultrasound lung comets during ascent appeared in 15 of 18 subjects (83%) at 3440 m above sea level and in 18 of 18 subjects (100%) at 4790 m above sea level in the presence of normal left and right ventricular function and pulmonary artery systolic pressure rise (sea level = 24 +/- 5 mm Hg vs. peak ascent = 42 +/- 11 mm Hg, p < .001). Ultrasound lung comets were absent at baseline (day 2, altitude 1350 m, 1.06 +/- 1.3), increased progressively during the ascent (day 14, altitude 5130 m: 16.5 +/- 8; p < .001 vs. previous steps), and decreased at descent (day 20, altitude 1355 m: 2.9 +/- 1.7; p = nonsignificant vs. baseline). An ultrasound lung comet score showed a negative correlation with O(2) saturation (R = -.7; p < .0001). CONCLUSIONS: In recreational climbers, chest sonography revealed a high prevalence of clinically silent interstitial pulmonary edema mirrored by decreased O(2) saturation, whereas no statistically significant relationship with pulmonary artery systolic pressure was observed during ascent.
Authors:
Lorenza Pratali; Marco Cavana; Rosa Sicari; Eugenio Picano
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  38     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1818-23     Citation Subset:  AIM; IM    
Affiliation:
Institute of Clinical Physiology, CNR, Pisa, Italy. lorenza@ifc.cnr.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Altitude*
Female
Humans
Male
Middle Aged
Mountaineering*
Nepal
Pulmonary Edema / ultrasonography*
Recreation
Thorax / ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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