Document Detail

Hemodynamic effects of altitude exposure and oxygen administration in chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  8475934     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Cardiovascular events are the leading cause of death during air travel. Because patients with chronic obstructive pulmonary disease (COPD) develop severe hypoxemia at altitude, we sought to determine whether changes in systemic hemodynamics may contribute to health risks during hypobaric hypoxia. PATIENTS AND METHODS: We recorded radial artery catheter blood pressure, cardiac frequency, and cardiac ectopy in 18 men (aged 68 +/- 6 years, mean +/- SD) with severe COPD (forced expiratory volume in 1 second 0.97 L +/- 0.32 L) at sea level, after 45 minutes of steady-state hypobaric hypoxia at 2,438 m in a hypobaric chamber, and after oxygen supplementation at 2,438 m. RESULTS: Mean arterial pressure (mm Hg), systolic blood pressure (SBP), diastolic blood pressure, and pulsus paradoxus during acute hypobaric exposure did not differ from baseline. During oxygen supplementation, SBP declined (p = 0.028). Decreases in pulsus paradoxus and pulse pressure were noted on oxygen (p < 0.05). We found no changes in cardiac frequency. Cardiac ectopy was uncommon; for one subject, ectopy increased with hypobaric hypoxia and decreased with oxygen administration. CONCLUSION: Vasopressor responses to hypoxia do not add to the risk of air travel in patients with severe COPD. Supplemental oxygen may cause beneficial hemodynamic changes in patients with COPD during acute hypobaric exposure.
B W Berg; T A Dillard; S S Derderian; K R Rajagopal
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  94     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-20     Completed Date:  1993-05-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  407-12     Citation Subset:  AIM; IM; S    
Department of Medicine, Walter Reed Army Medical Center, Washington, D.C. 20307-5001.
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MeSH Terms
Aerospace Medicine
Anoxia / epidemiology,  etiology*,  therapy
Arrhythmias, Cardiac / epidemiology,  etiology
Blood Gas Analysis
Blood Pressure
Evaluation Studies as Topic
Forced Expiratory Volume
Heart Rate
Lung Diseases, Obstructive / complications*,  diagnosis
Oxygen Inhalation Therapy / standards*

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