| Frequent subclinical high-altitude pulmonary edema detected by chest sonography as ultrasound lung comets in recreational climbers. | |
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MedLine Citation:
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PMID: 20562696 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Lorenza Pratali; Marco Cavana; Rosa Sicari; Eugenio Picano |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 38 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-09-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1818-23 Citation Subset: AIM; IM |
Affiliation:
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Institute of Clinical Physiology, CNR, Pisa, Italy. lorenza@ifc.cnr.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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