Aspects and necessity of moderate-altitude research

Domej, Wolfgang; Schwaberger, G.; Guger, Christoph; Herfert, J; Haditsch, Bernd; Földes-Papp, Zeno; Tilz, Gernot P.

doi:10.1007/s10354-005-0162-8

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…Enhanced generation of ROS is also induced by oxygenenriched inspired air, hypoxic atmosphere at altitude [12], OH, RNS exposition to ROS/RNS generating substances such as transition metals, e.g. chrome, vanadium or copper [13], activation of ROS generating enzyme systems, or release of iron from iron pools.…”

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confidence: 99%

Chronic Obstructive Pulmonary Disease and Oxidative Stress

Domej

Földes-Papp²,

Flogel³

et al. 2006

CPB

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The respiratory tract as the main entrance for various inhalative substances has great potential to generate reactive species directly or indirectly in excess. Thus, heavy smokers are at high risk for development, impairment and failed response to treatment of chronic obstructive pulmonary disease (COPD). The article is an update regarding the influence of reactive oxygen (ROS) and nitrogen (RNS) species on COPD; however, we do not intend to describe ROS and RNS actions on the entire lung tissue. Here, we focus on the airways, because in human most of the described effects of ROS and RNS species are measured on respiratory epithelial cells obtained by bronchoscopy. ROS and RNS species are physiological compounds in cells and risk factors for several respiratory diseases. In general, both kinds of species are thermodynamically stabile, but their reaction behaviors in cellular environments are very different. For example, the life times of the superoxide anion radical range from micro/milliseconds up to minutes and even hours in in-vitro model systems. Oxidative stress by cigarette smoke was investigated in detail by the authors of this article. In addition, original studies by the authors on the amount of fine particulate matter and trace elements in lung biopsies after defined inhalation indicate a distortion of the equilibrium between oxidants and antioxidants. We also try to present some modern views with respect to genomic medicine for future therapeutic perspectives, although this is an upcoming sector of COPD therapy.

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Section: Fig (1)mentioning

confidence: 99%

Chronic Obstructive Pulmonary Disease and Oxidative Stress

Domej

Földes-Papp²,

Flogel³

et al. 2006

CPB

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“…Annually, some 40 million people spend time in the Alpine zones and 100 million visit high altitudes worldwide [1]. Research in mountain medicine can help to pave the way towards safer and more effective approaches in the management of AMS.…”

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confidence: 99%

Altitude mountain sickness among tourist populations: a review and pathophysiology supporting management with hyperbaric oxygen

Butler¹,

Al-Waili²,

Passano³

et al. 2011

Journal of Medical Engineering & Technology

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In the mountain climbing community, conventional prevention of altitude mountain sickness (AMS) relies primarily on a formal acclimatization period. AMS symptoms during mountaineering climbs are managed with medication, oxygen and minor recompression (1524-2438 m altitude) using a portable chamber, such as the Gamow Bag. This is not always an acceptable therapy alternative in a predominantly elderly tourist population. The primary problem with reduced pressure at high altitude is hypoxaemia, which causes increased sympathetic activity, induces pulmonary venous constriction, while increasing pulmonary blood flow and regional perfusion. Rapid assents to altitude contribute to an increased incidence of decompression sickness (DCS). The treatment of choice for DCS is hyperbaric oxygenation, thus, treatment of high-altitude induced hypoxaemia using hyperbaric oxygenation (HBO(2)) is logical. Life Support Technologies group and the Center for Investigation of Altitude Medicine (CIMA, in Cusco, Peru) propose a comprehensive and multidisciplinary approach to AMS management. This approach encompasses traditional and advanced medical interventions including the use of a clinical HBO(2) chamber capable of recompression to three times greater than sea level pressure (3 atmosphere absolute (ATA)). The system uses a series of AMS hyperbaric treatment profiles that LST has previously developed to the US military and NASA, and that take greater advantage of vasoconstrictive effects of oxygen under true hyperbaric conditions of 1.25 ATA. These profiles virtually eliminate AMS rebound after the initial treatment often seen in conventional AMS treatment, where the patient is either treated at altitude, or does not recompress back to sea level or greater pressure (1.25 ATA), but returns directly to the same altitude where AMS symptoms first manifested.

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Auswirkungen akuter Höhenexposition: Welche Höhe ist gesundheitlich verträglich?

Burtscher

2010

Wien Med Wochenschr

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Exposures to natural and simulated altitudes are combined with a reduction of the available oxygen (hypoxia) and may provoke health problems or even emergencies. Although millions of people are living at high altitudes, are regularly or occasionally performing mountain sport activities, are transported by airplanes, and are increasingly frequently exposed to hypoxia at their workplace, e.g. with fire control systems, there is no consensus about the level of hypoxia which is well tolerated by most of human beings. Thus, the present mini review tries to define such a level. This review indicates that although humans show adaptive responses even to altitudes below 2000 m or corresponding normobaric hypoxia (FiO2: >16%) most of these subjects without severe pre-existing diseases well tolerate altitudes up to 3000 m (FiO2: 14.5%). If at all, symptoms of acute mountain sickness may develop in some persons after a minimum exposure time of about 6 hours. This also applies to children, elderly persons and pregnant women. Physical activity and unusual environmental conditions may increase the risk to get sick. Also patients with not severe cardiovascular, respiratory or metabolic diseases well tolerate such levels of altitude. However, individual differences in responses to hypoxia have to be considered and can at least partly be tested by simple hypoxia challenge tests. For safety reasons altitudes up to 2700 m or normobaric hypoxia up to FiO2 values of 15% are proposed to be well tolerated by most humans who are not severely diseased.

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Aspects and necessity of moderate-altitude research

Cited by 3 publications

References 31 publications

Chronic Obstructive Pulmonary Disease and Oxidative Stress

Chronic Obstructive Pulmonary Disease and Oxidative Stress

Altitude mountain sickness among tourist populations: a review and pathophysiology supporting management with hyperbaric oxygen

Auswirkungen akuter Höhenexposition: Welche Höhe ist gesundheitlich verträglich?

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